El Beshlawy A, Fawaz L, Hamdy M, Kamel AK, Mohamed W, Sabry A and Schaalan M
Background: Primary hypothyroidism is one of the most frequent endocrine complications observed in patients suffering from thalassemia where iodine deficiency is a major contributing factor. We aim at assessing the iodine status in multitransfused pediatrics with thalassemia major, compliant to iron chelation, to evaluate its contributing role to the occurring hypothyroidism for the potential future replacement therapy.
Procedure: Sixty young thalassemia patients (31 males, 29 females; aged 14.4 ± 3.83 years) were randomly selected from the hematology clinic of the Children’s Hospital, Cairo University, added to 36 age and sex matched control subjects.
Results: The study revealed a highly significant difference in urinary iodine, FT3, FT4 and TSH between the thalassemic group and their controls (P<0.001). Twenty seven patients (45%) had overt hypothyroidism (low T4 and elevated TSH >10 uIU/ml), and 34/36 had normal urinary iodine level. Severe iodine deficiency was manifested in 9/60 patients (15%), moderate deficiency in 27/60 patients (45%) and mild deficiency in 24/60 patients (40%). A negative correlation was found between urinary iodine and both serum ferritin and TSH (r=-0.413 at P<0.001, r=-0.881 at P<0.001; respectively).
Conclusion: To this end, iodine deficiency is at least partially responsible for the high prevalence of thalassemia–induced hypothyroidism among Egyptian young patients.
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