ASSESSMENT OF THYROID FUNCTION IN BETA THALASSEMIA MAJOR PATIENTS WITH MULTIPLE BLOOD TRANSFUSIONS: A CROSS-SECTIONAL STUDY
Keywords:
Beta thalassemia major, Hypothyroidism, ferritin, Thyroid function
Abstract
https://doi.org/10.31386/dmj.2024.18.1.6
Background: Its well known that thalassemia is the most prevalent genetic disorder worldwide. β thalassemia major is the basic form of thalassemia major that requires lifelong blood transfusions. one of the most prevalent endocrine issues in beta-thalassemia major is hypothyroidism. The current study was aimed to assess the thyroid function status in chronically transfused Beta thalassemia major patients.
Methods: A cross-sectional study included 278 patients diagnosed with beta thalassemia major. The study lasted for 12 months interval, from January 2021 to January 2022. Serum free thyroxine, thyroid stimulating hormone and Ferritin levels were measured for all patients using Roche Cobas 6000 analyzer.
Results: The study observed a high prevalence rate of subclinical hypothyroidism (41.2%) and as well as, (2.9%) had overt hypothyroidism. There was insignificant high level of serum ferritin among hypothyroid patients. Nineteen of the subclinical hypothyroid patients (16.5%) had splenectomy, whereas, no one with clinical hypothyroidism had splenectomy.
Conclusion: The study conclude that near half of beta thalassemia major patients were had overt hypothyroidism and subclinical hypothyroidism.
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References
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18. Mariotti, S., Pigliaru, F., Cocco, M.C., Spiga, A., Vaquer, S. and Lai, M.E., 2011. β-thalassemia and thyroid failure: is there a role for thyroid autoimmunity?. Pediatric endocrinology reviews: PER, 8, pp.307-309.
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21. Gamberini, M.R., De Sanctis, V. and Gilli, G., 2008. Hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism: incidence and prevalence related to iron overload and chelation therapy in patients with thalassaemia major followed from 1980 to 2007 in the Ferrara Centre. Pediatric endocrinology reviews: PER, 6, pp.158-169.
22. Eshragi, P., Tamaddoni, A., Zarifi, K., Mohammadhasani, A. and Aminzadeh, M., 2011. Thyroid function in major thalassemia patients: Is it related to height and chelation therapy?.
23. Jaruratanasirikul, S., Wongcharnchailert, M., Laosombat, V., Sangsupavanich, P. and Leetanaporn, K., 2007. Thyroid function in beta-thalassemic children receiving hypertransfusions with suboptimal iron-chelating therapy. JOURNAL-MEDICAL ASSOCIATION OF THAILAND, 90(9), p.1798.24. Filosa A., Di Maio S., Aloj G., Acampora C. Longitudinal study on thyroid function in patients with thalassemia major. Journal of Pediatric Endocrinology and Metabolism. 2006;19(12):1397–1403. [PubMed] [Google Scholar]
24. Singhal, A. and Goyal, H., 2020. Thyroid dysfunction in beta thalassemia major patients. Thyroid Research and Practice, 17(2), pp.70-75.
25. Khalid, N., Noreen, K., Qureshi, F.M. and Mahesar, M., 2019. Knowledge of thalassemia and consanguinity: A multicenter hospital based retrospective cohort study from metropolitan city of Karachi, Pakistan. The Professional Medical Journal, 26(09), pp.1580-1586.
26. Riaz, M., Abbas, M., Rasool, G., Baig, I.S., Mahmood, Z., Munir, N., Mahmood Tahir, I., Ali Shah, S.M. and Akram, M., 2022. Prevalence of transfusion-transmitted infections in multiple blood transfusion-dependent thalassemic patients in Asia: A systemic review. International Journal of Immunopathology and Pharmacology, 36, p.03946320221096909.
27. Bandyopadhyay, U., Kundu, D., Sinha, A., Banerjee, K., Bandyopadhyay, R., Mandal, T. and Ray, D., 2013. Conservative management of Beta-thalassemia major cases in the sub-division level hospital of rural West Bengal, India. Journal of natural science, biology and medicine, 4(1).
28. Gamberini, M.R., De Sanctis, V. and Gilli, G., 2008. Hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism: incidence and prevalence related to iron overload and chelation therapy in patients with thalassaemia major followed from 1980 to 2007 in the Ferrara Centre. Pediatric endocrinology reviews: PER, 6, pp.158-169.
29. De, P., Mistry, R., Wright, C., Pancham, S., Burbridge, W., Gangopadhayay, K., Pang, T. and Das, G., 2014. A review of endocrine disorders in thalassaemia. Open Journal of Endocrine and Metabolic Diseases, 2014.
30. Dr Deepmala A Budhrani, DR PRAFUL J DUDHREJIA, DR KANDAKUR SACHIN, DR HIREN N MAKWANA 2023. THYROID DYSFUNCTION IN THALASSEMIA MAJOR PATIENTS. European Journal of Molecular & Clinical Medicine, 10, 334-337.
31. Casale, M., Citarella, S., Filosa, A., De Michele, E., Palmieri, F., Ragozzino, A., Amendola, G., Pugliese, U., Tartaglione, I., Della Rocca, F. and Cinque, P., 2014. Endocrine function and bone disease during long‐term chelation therapy with deferasirox in patients with β‐thalassemia major. American journal of hematology, 89(12), pp.1102-1106.
32. Yassouf, M.Y., Alquobaili, F., Kabalan, Y. and Mukhalalaty, Y., 2019. Compliance with deferoxamine therapy and thyroid dysfunction of patients with β-thalassemia major in Syria. Hemoglobin, 43(3), pp.218-221.
33. Belhoul, K.M., Bakir, M.L., Saned, M.S., Kadhim, A.M., Musallam, K.M. and Taher, A.T., 2012. Serum ferritin levels and endocrinopathy in medically treated patients with β thalassemia major. Annals of hematology, 91, pp.1107-1114.
34. Skafida, M., Sofocleous, C., Kattamis, A. and Kattamis, C., 2019. Does Splenectomy Influence the Development of Hypothyroidism in Transfusion Dependent Thalassemia Patients? A Retrospective Study. Mediterranean Journal of Hematology and Infectious Diseases, 11(1).
2. De Sanctis, V., Eleftheriou, A. and Malaventura, C., 2004. Prevalence of endocrine complications and short stature in patients with thalassaemia major: a multicenter study by the Thalassaemia International Federation (TIF). Pediatric endocrinology reviews: PER, 2, pp.249-255.
3. Asad, Z.T., Ghazanfari, M., Naleini, S.N., Sabagh, A. and Kooti, W., 2016. Evaluation of serum levels in T3, T4 and TSH in beta-thalassemic patients referred to the Abuzar hospital in Ahwaz. Electronic physician, 8(7), p.2620.
4. Fibach, E. and Rachmilewitz, E.A., 2017. Pathophysiology and treatment of patients with beta-thalassemia–an update. F1000Research, 6.
5. Cappellini, M.D. and Motta, I., 2017. New therapeutic targets in transfusion-dependent and-independent thalassemia. Hematology 2014, the American Society of Hematology Education Program Book, 2017(1), pp.278-283.
6. De Sanctis, V., Elsedfy, H., Soliman, A.T., Elhakim, I.Z., Soliman, N.A., Elalaily, R. and Kattamis, C., 2016. Endocrine profile of β-thalassemia major patients followed from childhood to advanced adulthood in a tertiary care center. Indian journal of endocrinology and metabolism, 20(4), p.451.
7. Åsvold, B.O., Vatten, L.J. and Bjøro, T., 2013. Changes in the prevalence of hypothyroidism: the HUNT Study in Norway. European journal of endocrinology, 169(5), pp.613-620.
8. Garmendia Madariaga, A., Santos Palacios, S., Guillén-Grima, F. and Galofré, J.C., 2014. The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 99(3), pp.923-931.
9. Vanderpump, M.P., 2011. The epidemiology of thyroid disease. British medical bulletin, 99(1).
10. SALIH, S.F., HUSSEN, K.R. and AL-TIMIMI, D.J., 2019. Status of serum zinc levels in females with thyroid dysfunction. Duhok Medical Journal, 13(1), pp.74-82.
11. Chaker, L., Bianco, A.C., Jonklaas, J. and Peeters, R.P., 2018. Hypothyroidism and hypertension: fact or myth?–Authors' reply. The Lancet, 391(10115), p.30.
12. Gaitonde, D.Y., Rowley, K.D. and Sweeney, L.B., 2012. Hypothyroidism: an update. South African Family Practice, 54(5), pp.384-390.
13. Ferdaus, M.Z., Hasan, A.K.M.M. and Shekhar, H.U., 2010. Analysis of serum lipid profiles, metal ions and thyroid hormones levels abnormalities in β-thalassaemic children of Bangladesh. JPMA. The Journal of the Pakistan Medical Association, 60(5), p.360.
14. Mula-Abed, W.A., Al Hashmi, H., Al Muslahi, M., Al Muslahi, H. and Al Lamki, M., 2008. Prevalence of endocrinopathies in patients with Beta-thalassaemia major-a cross-sectional study in oman. Oman medical journal, 23(4), p.257.
15. Malik, S.A., Syed, S. and Ahmed, N., 2010. Frequency of hypothyroidism in patients of b-thalassemia. J Pak Med Assoc, 60(1), pp.17-20.
16. De Sanctis, V., De Sanctis, E., Ricchieri, P., Gubellini, E., Gilli, G. and Gamberini, M.R., 2008. Mild subclinical hypothyroidism in thalassaemia major: prevalence, multigated radionuclide test, clinical and laboratory long-term follow-up study. Pediatric Endocrinology Reviews: PER, 6, pp.174-180.
17. Kurtoglu, A.U., Kurtoglu, E. and Temizkan, A.K., 2012. Effect of iron overload on endocrinopathies in patients with beta-thalassaemia major and intermedia. Endokrynologia Polska, 63(4), pp.260-263.
18. Mariotti, S., Pigliaru, F., Cocco, M.C., Spiga, A., Vaquer, S. and Lai, M.E., 2011. β-thalassemia and thyroid failure: is there a role for thyroid autoimmunity?. Pediatric endocrinology reviews: PER, 8, pp.307-309.
19. De Sanctis, V., Soliman, A., Campisi, S. and Yassin, M., 2012. Thyroid disorders in thalassaemia: An update. Current trends in endocrinology, 6.
20. Skordis, N., Michaelidou, M., Savva, S.C., Ioannou, Y., Rousounides, A., Kleanthous, M., Skordos, G. and Christou, S., 2006. The impact of genotype on endocrine complications in thalassaemia major. European journal of haematology, 77(2), pp.150-156.
21. Gamberini, M.R., De Sanctis, V. and Gilli, G., 2008. Hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism: incidence and prevalence related to iron overload and chelation therapy in patients with thalassaemia major followed from 1980 to 2007 in the Ferrara Centre. Pediatric endocrinology reviews: PER, 6, pp.158-169.
22. Eshragi, P., Tamaddoni, A., Zarifi, K., Mohammadhasani, A. and Aminzadeh, M., 2011. Thyroid function in major thalassemia patients: Is it related to height and chelation therapy?.
23. Jaruratanasirikul, S., Wongcharnchailert, M., Laosombat, V., Sangsupavanich, P. and Leetanaporn, K., 2007. Thyroid function in beta-thalassemic children receiving hypertransfusions with suboptimal iron-chelating therapy. JOURNAL-MEDICAL ASSOCIATION OF THAILAND, 90(9), p.1798.24. Filosa A., Di Maio S., Aloj G., Acampora C. Longitudinal study on thyroid function in patients with thalassemia major. Journal of Pediatric Endocrinology and Metabolism. 2006;19(12):1397–1403. [PubMed] [Google Scholar]
24. Singhal, A. and Goyal, H., 2020. Thyroid dysfunction in beta thalassemia major patients. Thyroid Research and Practice, 17(2), pp.70-75.
25. Khalid, N., Noreen, K., Qureshi, F.M. and Mahesar, M., 2019. Knowledge of thalassemia and consanguinity: A multicenter hospital based retrospective cohort study from metropolitan city of Karachi, Pakistan. The Professional Medical Journal, 26(09), pp.1580-1586.
26. Riaz, M., Abbas, M., Rasool, G., Baig, I.S., Mahmood, Z., Munir, N., Mahmood Tahir, I., Ali Shah, S.M. and Akram, M., 2022. Prevalence of transfusion-transmitted infections in multiple blood transfusion-dependent thalassemic patients in Asia: A systemic review. International Journal of Immunopathology and Pharmacology, 36, p.03946320221096909.
27. Bandyopadhyay, U., Kundu, D., Sinha, A., Banerjee, K., Bandyopadhyay, R., Mandal, T. and Ray, D., 2013. Conservative management of Beta-thalassemia major cases in the sub-division level hospital of rural West Bengal, India. Journal of natural science, biology and medicine, 4(1).
28. Gamberini, M.R., De Sanctis, V. and Gilli, G., 2008. Hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism: incidence and prevalence related to iron overload and chelation therapy in patients with thalassaemia major followed from 1980 to 2007 in the Ferrara Centre. Pediatric endocrinology reviews: PER, 6, pp.158-169.
29. De, P., Mistry, R., Wright, C., Pancham, S., Burbridge, W., Gangopadhayay, K., Pang, T. and Das, G., 2014. A review of endocrine disorders in thalassaemia. Open Journal of Endocrine and Metabolic Diseases, 2014.
30. Dr Deepmala A Budhrani, DR PRAFUL J DUDHREJIA, DR KANDAKUR SACHIN, DR HIREN N MAKWANA 2023. THYROID DYSFUNCTION IN THALASSEMIA MAJOR PATIENTS. European Journal of Molecular & Clinical Medicine, 10, 334-337.
31. Casale, M., Citarella, S., Filosa, A., De Michele, E., Palmieri, F., Ragozzino, A., Amendola, G., Pugliese, U., Tartaglione, I., Della Rocca, F. and Cinque, P., 2014. Endocrine function and bone disease during long‐term chelation therapy with deferasirox in patients with β‐thalassemia major. American journal of hematology, 89(12), pp.1102-1106.
32. Yassouf, M.Y., Alquobaili, F., Kabalan, Y. and Mukhalalaty, Y., 2019. Compliance with deferoxamine therapy and thyroid dysfunction of patients with β-thalassemia major in Syria. Hemoglobin, 43(3), pp.218-221.
33. Belhoul, K.M., Bakir, M.L., Saned, M.S., Kadhim, A.M., Musallam, K.M. and Taher, A.T., 2012. Serum ferritin levels and endocrinopathy in medically treated patients with β thalassemia major. Annals of hematology, 91, pp.1107-1114.
34. Skafida, M., Sofocleous, C., Kattamis, A. and Kattamis, C., 2019. Does Splenectomy Influence the Development of Hypothyroidism in Transfusion Dependent Thalassemia Patients? A Retrospective Study. Mediterranean Journal of Hematology and Infectious Diseases, 11(1).
Published
2024-06-07
How to Cite
I. A. BADI, A. (2024). ASSESSMENT OF THYROID FUNCTION IN BETA THALASSEMIA MAJOR PATIENTS WITH MULTIPLE BLOOD TRANSFUSIONS: A CROSS-SECTIONAL STUDY. Duhok Medical Journal, 18(1), 49-58. Retrieved from https://dmj.uod.ac/index.php/dmj/article/view/299
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