Thyroid Status in Children with Transfusion Dependent Thalassemia in a Tertiary Level Hospital.

Mymensingh medical journal : MMJ Pub Date : 2024-10-01
J Ferdousi, R Parveen, S K Dhar, M A Hossain, M N Islam, P K Shil, T Tazmin, M S Alam, U Devi, S Parvin, S E Amin, A Jahan, T B Belayet, N Noshin
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Abstract

Most of the thalassemic children of Bangladesh are receiving repeated blood transfusion. But they do not receive chelation therapy due to financial constraints. As a result, iron overload occurs in various organs of these children. Extra iron that is loaded in thyroid gland causes thyroid dysfunction. This study was undertaken to evaluate thyroid status in children with transfusion dependent Thalassemia patient. This cross-sectional analytical study was conducted in the Department of Pediatrics, Mymensingh Medical College Hospital, Bangladesh from September 2016 to April 2018. Children having thalassemia diagnosed by Hb electrophoresis, aged 3-12 years of both sexes were included as study group. Children of same age and sex admitted in indoor of Mymensingh Medical College Hospital with minor illness and without thalassemia were taken as comparison group. Purposive Sampling technique was applied. Serum FT₄, TSH and ferritin level were estimated in all children. Data analysis was done with Statistical Package for Social Science (SPSS) version 21.0. A total of 60 patients were enrolled as study group and another 60 patients were compared as comparison group. Mean ages of study group was 7.88±2.55 years and comparison group were 7.22±2.48 years. The mean pre-transfusion hemoglobin, serum ferritin, serum FT₄ and serum TSH level were found 6.23±0.60 gm/dl, 2658.33±879.39 ng/ml, 15.14±4.40 fmol/mL, 4.29±4.60 μIU/mL respectively in study group. The mean serum FT₄ was found significantly lower and mean serum TSH was significantly higher in thalassemic children in comparison to non-thalassemic children (p= <0.05). Frequency of subclinical hypothyroidism was found significantly higher in study group (25.0%) compared to comparison group (3.3%) (p=0.001). Mean serum ferritin level was found significantly higher in hypothyroid cases. Mean FT₄ level was significantly lower and mean TSH level was significantly higher in hypothyroid thalassemic patients (p= <0.001). Significant positive correlation between serum ferritin level and serum TSH level was found. Higher serum ferritin level was found significantly associated with the development of hypothyroidism in thalassemic patients.

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一家三级医院输血依赖型地中海贫血患儿的甲状腺状况
孟加拉国的大多数地中海贫血儿童都在接受反复输血。但由于经济拮据,他们没有接受螯合疗法。因此,这些儿童的各个器官都出现了铁超载。甲状腺中多余的铁会导致甲状腺功能障碍。本研究旨在评估输血依赖型地中海贫血患儿的甲状腺状况。这项横断面分析研究于2016年9月至2018年4月在孟加拉国迈门辛医学院附属医院儿科进行。研究对象包括通过血红蛋白电泳确诊为地中海贫血的 3-12 岁男女儿童。在迈门辛医学院医院室内因轻微疾病住院且未患地中海贫血症的同年龄、同性别儿童作为对比组。采用有目的的抽样技术。对所有儿童的血清 FT₄、促甲状腺激素和铁蛋白水平进行了估计。数据分析采用 21.0 版社会科学统计软件包(SPSS)进行。共有 60 名患者作为研究组,另外 60 名患者作为对比组。研究组的平均年龄为(7.88±2.55)岁,对比组为(7.22±2.48)岁。研究组输血前平均血红蛋白、血清铁蛋白、血清 FT₄和血清 TSH 水平分别为 6.23±0.60 gm/dl、2658.33±879.39 ng/ml、15.14±4.40 fmol/mL、4.29±4.60 μIU/mL。与非地中海贫血症儿童相比,地中海贫血症儿童的平均血清 FT₄明显降低,平均血清 TSH 明显升高(p=0.05)。
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