ESPE Abstracts

Introduction: Β-thalassemia is a hereditary chronic hemolytic anemia characterized by a defect in the synthesis of beta-globin chains, particularly common in the Mediterranean region, southern Asia, and the Middle East Transfusion programs and chelation therapy have greatly extended the life expectancy of patients. This has led to an increase in the prevalence of endocrine complications, linked to iron overload The hypothyroidism is one of the most commonly reported complications in patients with polytransfused beta thalassemia. Thyroid dysfunction is directly linked to the degree of iron overload.

Objectives: Describe the frequency of hypothyroidism in patients with polytransfused β-thalassemia. Study the linking between hypothyroidism and the ferritinemia rate, the average transfusion volume (MTV), the duration of transfusion therapy, splenectomy, and compliance with chelating therapy.

Method: It is a descriptive, analytical and mono-centric cross-sectional study which was carried out in the pediatric department of CHU Mustapha and which involved 87 patients (46 Girls and 41 Boys), followed for several years on a regular basis and treated by a transfusion regime (more than 10 transfusions) combined with a chelating treatment. All patients were evaluated by a clinical history, a somatic examination, and then a determination of free T4 (FT4) and thyroid stimulating hormone (TSH).

Results: Primary hypothyroidism is present in 16 (18.4%) patients, this hypothyroidism is subclinical in 12 (13.8%) patients and obvious in 04 (4.6%) patients. The average age of patients with hypothyroidism was 12 ± 5.3 years. Hypothyroidism was observed in 11 boys and 05 girls. Hypothyroidism was asymptomatic in all β-thalassemia patients at the time of diagnosis, no patient had goiter, and no central hypothyroidism was observed. There is a significant correlation between hypothyroidism and the ferritinemia level in our study.

Conclusion: Hypothyroidism in thalassemia develops as a result of siderosis of thyroid cells, usually seen in the second decade of life. An annual assessment of thyroid function is recommended in polytransfused β-thalassemic patients from the age of 10 years. Recognizing and treating hypothyroidism early in thalassemia help improve the quality of life for these patients.