Volume 33
Number 4 (2024)Thyroid Status in Children with Transfusion Dependent Thalassemia in a Tertiary Level Hospital
DOI: https://doi.org/10.XXXXX/mmj.2024.v3304.03
Ferdousi J1 , Parveen R2 , Dhar SK3 , Hossain MA4 , Islam MN5 , Shil PK6 , Tazmin T7 , Alam MS8 , Devi U9
Abstract
Most of the thalassemic children of Bangladesh are receiving repeated blood transfusion. But they do not receive chelation therapy due to financial constraints. As a result, iron overload occurs in various organs of these children. Extra iron that is loaded in thyroid gland causes thyroid dysfunction. This study was undertaken to evaluate thyroid status in children with transfusion dependent Thalassemia patient. This cross-sectional analytical study was conducted in the Department of Pediatrics, Mymensingh Medical College Hospital, Bangladesh from September 2016 to April 2018. Children having thalassemia diagnosed by Hb electrophoresis, aged 3-12 years of both sexes were included as study group. Children of same age and sex admitted in indoor of Mymensingh Medical College Hospital with minor illness and without thalassemia were taken as comparison group. Purposive Sampling technique was applied. Serum FT4, TSH and ferritin level were estimated in all children. Data analysis was done with Statistical Package for Social Science (SPSS) version 21.0. A total of 60 patients were enrolled as study group and another 60 patients were compared as comparison group. Mean ages of study group was 7.88±2.55 years and comparison group were 7.22±2.48 years. The mean pre-transfusion hemoglobin, serum ferritin, serum FT4 and serum TSH level were found 6.23±0.60 gm/dl, 2658.33±879.39 ng/ml, 15.14±4.40 fmol/mL, 4.29±4.60 µIU/mL respectively in study group. The mean serum FT4 was found significantly lower and mean serum TSH was significantly higher in thalassemic children in comparison to non-thalassemic children (p= <0.05). Frequency of subclinical hypothyroidism was found significantly higher in study group (25.0%) compared to comparison group (3.3%) (p=0.001). Mean serum ferritin level was found significantly higher in hypothyroid cases. Mean FT4 level was significantly lower and mean TSH level was significantly higher in hypothyroid thalassemic patients (p= <0.001). Significant positive correlation between serum ferritin level and serum TSH level was found. Higher serum ferritin level was found significantly associated with the development of hypothyroidism in thalassemic patients.
Keywords: Thyroid status, Children, Transfusion dependent, Thalassemia
- Department of Paediatrics
- Assistant Professor, Paediatric Gastroenterology & Nutrition
- Junior Consultant (Paediatrics)
- Ex-Principal & Head, Department of Neonatology
- Head, Department of Neonatology
- Registrar (Paediatrics) of Paediatrics
- Specialist, Child Development Centre
- Indoor Medical Officer, Oral & Maxillofacial Surgery
- Assistant Professor, Paediatrics