Abstract:

Purpose: Thyroid dysfunction is an important complication of Beta-Thalassemia major (β-TM). The reason may be iron overload or autoimmunity. Methods: In this study, 129 patients with β-TM were included. Free thyroxine (fT4), thyroid-stimulating hormone (TSH), anti-thyroid peroxidase, anti-thyroglobulin, and ferritin levels were measured. As the control group, 49 patients who applied to the hospital and requested TSH and fT4 were randomly selected. Both groups were compared in terms of thyroid dysfunction. Also, patients with thyroid dysfunction in the β-TM group were investigated in terms of underlying hyperferritinemia and autoimmune susceptibility. Results: In the β-TM group, overt and subclinical hypothyroidism were detected in 11 (8.5%) and three patients (2.4%), respectively. Ferritin levels of those with hypothyroidism were higher than the patients with normal thyroid dysfunction (p=0.006, z=-2.734). Anti-thyroid antibodies were not elevated in any of the patients with thyroid dysfunction. One (2%) patient had central hypothyroidism in the control group, and six (12.2%) patients had subclinical hypothyroidism. The number of overt hypothyroidism in thalassemia cases was statistically higher than in the control group (p=0.002). Conclusion: Our findings suggest that autoimmunity may not pose a risk factor for the development of hypothyroidism in β-TM patients, rather high ferritin levels may be a reason.

Keywords: