STUDY OF THYROID PROFILE IN BETA THALASSEMIA MAJOR CHILDREN OF NORTH BIHAR AND ITS CORRELATION WITH SERUM FERRITIN LEVELS

BACKGROUND Thalassemia major is an inherited disease, caused by abnormal hemoglobin synthesis that results from alteration in the rate of globin chain production. Blood transfusion in beta-thalassemia patient is essential for prolonging life. There may be an overload of iron with repeated blood transfusion and inadequate iron chelation therapy, which can lead to various endocrine complications such as hypothyroidism, cardiomyopathy, growth hormone deficiency, diabetes mellitus, hypoparathyroidism and hypogonadotropic gonadism. We wanted to study the incidence of Hypothyroidism in children with thalassemia major on regular blood transfusion and its correlation with serum ferritin levels that indicate iron overload in thalassemia patients. METHODS 50 children with beta-thalassemia major, who received regular blood transfusion therapy for at least two years and was selected with a ferritin level greater than 1000 mu gm/dl. Important history with clinical examination of each patient was recorded. Thyroid function tests and serum ferritin value were recorded from the patient's data and analysed. RESULTS 24% of patients were subclinical hypothyroidism and 2% had overt hypothyroidism. Incidence of hypothyroidism has no direct correlation with serum ferritin level in this study. CONCLUSIONS Hypothyroidism was seen in about 26% of children with thalassemia major in our study. Detecting hypothyroidism is important for patient because effective thyroid hormone replacement therapy is easy and possible. Therefore, thyroid function test should be monitored from time to time, especially when there are complications related to iron overload. With early identification and prevention of various endocrine complications it is possible to maintain the life of these children fairly comfortably and also increase the life expectancy.