Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, cilt.14, sa.3, ss.377-382, 2023 (Hakemli Dergi)
ABSTRACT
Purpose: Thyroid dysfunction is an important complication of beta-thalassemia major (β-TM). Iron overload is the most important cause of thyroid dysfunction in this patient group. However, it has been investigated in various studies whether autoimmunity can also cause thyroid dysfunction. This study aimed to determine the frequency of thyroid dysfunction
in β-TM and investigate whether the underlying disorder causing thyroid dysfunction is iron overload or autoimmunity.
Methods: This study analyzed 129 patients with β-TM. Free thyroxine (fT4), thyroid-stimulating hormone (TSH), antithyroid peroxidase, antithyroglobulin, 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. In the β-TM group, patients with thyroid dysfunction were evaluated for underlying hyperferritinemia and autoimmune susceptibility.
Results: In the β-TM group, overt and subclinical hypothyroidism were detected in 11 (8.5%) and 3 (2.4%) patients, respectively. The ferritin levels of those with hypothyroidism were higher than those with normal thyroid dysfunction (p = 0.006, z = −2.734). Levels of antithyroid antibodies did not increase in any of the patients with thyroid dysfunction. In
the control group, 1 (2%) patient had central hypothyroidism, and 6 (12.2%) had subclinical hypothyroidism. The number of overt hypothyroidism in thalassemia cases was statistically higher than that in the control group (p = 0.002).
Conclusion: The results suggest that autoimmunity may not pose a risk factor for the development of hypothyroidism in patients with β-TM, but high ferritin levels may be a reason.