EVALUATION OF THYROID HORMONES IN ? -THALASSEMIC CHILDREN OF NORTH INDIA

Aim and objectives: ?-thalassemia arises from a defect in the ? globulin chain synthesis from clinically silent heterogeneous
thalassemia minor to severe transfusion dependent thalassemia major. Transfusion related iron overload is the primary therapeutic
complication in ?-thalassemia major which leads to peroxidative stress and adversely affects the functioning of multiple organs.
Hypothalamic–pituitary –thyroid axis, para-thyroid, adrenal, pancreas, gonads, all may show hypo-activity. The prognosis depends on
the amount and the duration of iron overload. Therefore the aim of this study was to evaluate the thyroid hormones in patients with ?
TM in a children’s hospital in New Delhi, India.
Materials and Methods: 68 patients (aged 1-12 years) with ? -thalassemia major that undergo periodical blood transfusion at Chacha
Nehru Bal Chikitsalya Hospital, New Delhi were included in the study. The diagnosis was based on clinical examination and
haematological and haemoglobin electrophoresis profile. Serum levels of ferritin, iron, thyroid hormones FT3, FT4 and TSH levels
along with bilirubin and transaminases were estimated in all children.
Results: Subclinical hypothyroidism was observed in 23 patients (34%), who were further divided into 2 groups: – compensated
hypothyroidism which included 16 patients (24%) and decompensated hypothyroidism with 7 patients (10%). 45 patients (66%) were
found to be euthyroid. No significant worsening of thyroid profile was observed after one year of study.
Conclusion: Hypothyroidism is a frequent complication of excess iron load in thalassemia major patients. It is not clinically observed
in most thalassemia major patients and regular monitoring for the early detection and timely treatment of the disorder should be
implemented in all thalassemic children.