Assessment of thyroid function in children aged 1-13 years with Beta-thalassemia major

Ayfer Gözü Pirinççioğlu1, Turgay Deniz, Deniz Gökalp

  • 1Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey.

Insights

Hypothyroidism can occur in children with beta-thalassemia major during their first decade of life, contrary to previous assumptions. This is linked to significantly higher iron overload in these patients.

Area of Science:

  • Pediatric Endocrinology
  • Hematology
  • Metabolic Disorders

Background:

  • Beta-thalassemia major is a genetic blood disorder requiring lifelong transfusions.
  • Iron overload is a common complication in beta-thalassemia major patients.
  • Hypothyroidism is often associated with iron overload and typically appears later in life.

Purpose of the Study:

  • To investigate thyroid dysfunction in children with beta-thalassemia major.
  • To determine if hypothyroidism occurs earlier in life in these patients.
  • To assess the relationship between iron overload and thyroid function.

Main Methods:

  • Evaluated thyroid function (FT4, FT3, T3, T4, TSH) and ferritin levels in 90 children with beta-thalassemia major.
  • Compared patient thyroid parameters and ferritin levels to an age-sex matched healthy control group.
  • Administered thyrotropin-releasing hormone tests to patients with elevated TSH.

Main Results:

  • Patients with beta-thalassemia major exhibited significantly higher serum ferritin levels compared to controls.
  • Most thyroid function tests were within normal ranges, but three patients showed elevated TSH levels.
  • Elevated TSH levels indicated subclinical primary hypothyroidism in affected patients.

Conclusions:

  • Hypothyroidism can manifest in the first decade of life in beta-thalassemia major patients.
  • Early-onset hypothyroidism in this population may occur despite advancements in hematological care.
  • Iron overload is a critical factor to monitor for thyroid health in pediatric beta-thalassemia major.
Abstract

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