Frequecy of hypothyroidism In multi-transfused thalassemic patients in AL- Diwanyia Maternity ??children Hospital

Abstract

         Back ground: hypothyroidism in thalassemic children is not uncommon problem ? and need special attention and frequent patient monitoring.

Objective: to establish the frequency of  hypothyrodism among multitransfused

thalassemic patients depending on clinical and laboratory investigations.

Methods: A cross sectional study of thyroid function ,T3,T4, and TSH, was  carried out in 120 transfusion-dependent thalassemia and sickle cell anemia   patients attended the thalassemic Center in AL-Diwanyia Maternity and  Children.Teaching Hospital .The inclusion criteria were 1(the age more than 5  years and 2)receiving frequent blood transfusions at least 6 times per year in the last three years.

Result: eight patients have hypothyroidism and had a prevalence of (6.66%).     Two patients had low T3 and T4 and elevated TSH with signs and symptoms of hypothyroidism and was already treated with thyroxin ,which consistent with   the diagnosis of primary hypothyroidism , and 6 patients had no signs and symptoms of hypothyroidism with normal T3 and T4 but elevated TSH and this was consistent with the diagnosis of subclinical hypothyroidism . No patient of   these 8 have family history of hypothyroidism . All affected patients are receiving

 blood transfusions more than 20 times since the time of diagnosis and all the effected patients have suboptimal  iron –chelating therapy as reflected by the high  serum ferritin level ( < 1000 ).

Conclusion: patient with transfusion dependent hemoglobinpathy need frequent monitoring of their thyroid function at least once yearly to detect early  hypothyroidism and start early treatment .