ASSESSMENT OF STATUS OF THYROID FUNCTIONS IN CHILDREN WITH Β-THALASSEMIA MAJOR

Abstract

Background: β-thalassemia major is a hereditary blood disorder characterized by defective hemoglobin synthesis leading to severe anemia and lifelong dependence on blood transfusions.

Objective: To assess the status of thyroid function in children with β-thalassemia major and determine its association with age, duration of blood transfusions, serum ferritin levels, and compliance with iron chelation therapy.

Methdology: This cross-sectional study was conducted at the Department of Pediatrics, Fauji Foundation Hospital, Rawalpindi from December 2024 to May 2025. A total of 305 children were included. Children fulfilling the selection criteria were enrolled after obtaining informed consent from their parents or guardians. Demographic details, including age, gender, residence, socioeconomic status, and treatment history, were recorded. A 3 mL venous blood sample was drawn to assess thyroid function tests (TSH, T3, and T4).

Results: The mean age of the participants was 8.6 ± 3.4 years, with 178 (58.4%) males and 127 (41.6%) females. Abnormal thyroid function was detected in 28 children (9.2%), including 21 (6.9%) with subclinical hypothyroidism and 7 (2.3%) with overt hypothyroidism. A significant association was found between thyroid dysfunction and higher serum ferritin levels (p = 0.002), longer duration of transfusions (p = 0.001), increasing age (p = 0.04), and irregular chelation therapy (p = 0.01).

 Conclusion: It is concluded that thyroid dysfunction is a frequent and important endocrine complication in children with β-thalassemia major, commonly presenting as subclinical hypothyroidism. The risk increases with advancing age, prolonged transfusion therapy, higher ferritin levels, and poor adherence to chelation therapy.