Thyroid Function in Chronically Transfused Children with Beta Thalassemia Major: A Cross-Sectional Hospital Based...

Area of Science:

• Pediatric Endocrinology
• Hematology
• Genetics

Background:

• Beta Thalassemia Major (BTM) is a prevalent global genetic disorder.
• Iron chelation therapy improves survival but increases endocrine complications, including hypothyroidism.
• Hypothyroidism affects 6-30% of BTM children, often due to iron overload and tissue hypoxia.

Purpose of the Study:

• To assess thyroid function in chronically transfused BTM children across their first and second decades of life.
• To investigate the impact of transfusion duration, volume, serum ferritin, and chelation therapy on thyroid function.

Main Methods:

• Included 83 BTM children (≥3 years) with serum ferritin >1500 mcg/l on regular transfusions.
• Assessed thyroid function (TSH, FT4) and ferritin levels using ELISA kits.
• Excluded autoimmune thyroiditis via antibody testing (anti-TPO, anti-TgAb).

Main Results:

• 4.8% of BTM children exhibited subclinical hypothyroidism (2 in each decade of life).
• Children with thyroid dysfunction had elevated TSH (6.38 ± 0.83 mIU/ml) and ferritin (3983.0±1698.30 ng/ml).
• Higher TSH levels correlated significantly with thyroid dysfunction in the second decade (p=0.001); no other significant correlations found.

Conclusions:

• Subclinical hypothyroidism is the primary thyroid dysfunction in this BTM cohort.
• Effective iron chelation and regular transfusions may potentially lower the incidence of thyroid dysfunction.