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Study of thyroid function in Egyptian children with β-thalassemia major and β-thalassemia intermedia
Abdel-Rahman A Abdel-Razek1, Amina Abdel-Salam, Marwa M El-Sonbaty
1aDepartment of Pediatrics, New Children's Hospital, Cairo University Departments of bChild Health cMedical Biochemistry, National Research Center, Cairo, Egypt.
Insights
Subclinical hypothyroidism affects nearly 20% of Egyptian children with beta-thalassemia, regardless of disease type or iron overload. Early thyroid function screening and treatment are recommended for these patients.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Thalassemia Research
Background:
- Thyroid dysfunction is a recognized complication in transfusion-dependent beta-thalassemia.
- Data on the prevalence and risk factors of thyroid dysfunction in Egyptian children with beta-thalassemia is limited.
Purpose of the Study:
- To determine the frequency of functional thyroid abnormalities in young patients with beta-thalassemia.
- To compare thyroid function between beta-thalassemia major (TM) and beta-thalassemia intermedia (TI) patients.
Main Methods:
- A cross-sectional study involving 52 children with beta-thalassemia (ages 12-18).
- Assessment of thyroid function (free T3, free T4, TSH) and iron load (serum ferritin).
- Categorization into TM (34 patients) and TI (18 patients).
Main Results:
- The frequency of subclinical hypothyroidism was 19.2% among all studied children.
- No significant differences in thyroid profiles were observed between TM and TI patients.
- No correlations were found between thyroid dysfunction and iron load, chelation therapy, or transfusion frequency.
Conclusions:
- Children with both TM and TI are susceptible to subclinical thyroid dysfunction.
- Iron overload status does not appear to influence the risk of subclinical hypothyroidism.
- Routine thyroid function evaluation and timely treatment for subclinical hypothyroidism should be integrated into beta-thalassemia management protocols.
Background:
Thyroid dysfunction is a known complication of transfusion-dependent β-thalassemia. However, information on its frequency and risk factors among Egyptian Children is still unclear.
Objective:
We aimed to determine the frequency of functional thyroid abnormalities among young patients with β-thalassemia and compare the thyroid function status among patients with β-thalassemia major (TM) and β-thalassemia intermedia (TI).
Materials And Methods:
This was a cross-sectional study that included 52 β-thalassemia children [27 boys and 25 girls; 34 (65.4%) with TM and 18 (34.6%) with TI]. Their mean age was 16.0±1.91 (range: 12-18) years. Thyroid function and iron load status were assessed by measurement of free tetraiodothyronine, free triiodothyronine, thyroid stimulating hormone (TSH), and serum ferritin concentrations.
Results:
Serum TSH of the studied cases ranged from 0.28 to 25 μIU/ml with a mean of 4.5±4.8 μIU/ml. None of the studied cases had overt primary hypothyroidism and the frequency of subclinical hypothyroidism was 19.2%. No risk factors for thyroid dysfunction could be identified among our cases. The thyroid profile was comparable in TM and TI patients (P>0.05) and the frequency of subclinical hypothyroidism among TM cases was 20.6% and it was comparable to the 16.7% found among TI patients (P>0.05). No correlations were found between TSH, serum ferritin, chelation therapy, and frequency of blood transfusion.
Conclusion And Recommendations:
Both TM and TI patients are at risk for subclinical thyroid failure regardless of their iron overload status. Early evaluation of thyroid function in β-thalassemia children and thyroid replacement therapy for subclinical hypothyroidism should be introduced in the treatment protocols.
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