Publication: Study on Association of Serum Ferritin With Thyroid Profile And Oral Glucose Tolerance Test in Thalassemia Major Children
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Paediatric Society (JNPS)
Abstract
Abstract:
Introduction: The free iron and haemosiderosis-induced damage of the endocrine glands cause endocrinopathies such as abnormal glucose tolerance and hypothyroidism in transfusion - dependent beta-thalassemia major patients. Our objective was to study the association of serum ferritin level with thyroid dysfunctions; abnormal blood glucose tolerance and to see if they appear in the earlier period of life.
Methods: This cross-sectional study was done among thalassemia major children of two to 12 years in a tertiary care hospital, Kolkata, India. A pre-designed proforma was filled. Serum ferritin, fT4, TSH level, and oral glucose tolerance test (OGTT) were measured at presentation and noted in proforma.
Results: A total of 80 thalassemic children were studied. Fiftieth percentile cut off value (1414 ng/ml) of serum ferritin was found to be significant with associated variables like normal fT4, TSH, and OGTT. Out of all study subjects, 39 (51.3%) of normal fT4, 39 (54.9%) of normal TSH and 39 (52.0%) of normal OGTT had ferritin < 50th percentile (P < 0.05). Nine (11.3%) children had abnormal thyroid profiles and five (6.3%) children had abnormal OGTT having ferritin > 2000 ng/ml. At a cut off value of ferritin level > 1414 ng/ml, fT4, TSH and OGTT showed significant abnormality (p < 0.05 with df 1).
Conclusions: Ferritin is a good indirect marker to assess the risk of endocrine abnormality in thalassemic children. Frequent monitoring should be done once ferritin level crosses 1000 ng/ml. This will help in early detection and timely management of thalassemia related endocrinopathies.
Description
Kalimuddin Khan
Department of Paediatrics, Chittaranjan Seva Sadan College of Obstetrics Gynecology and Child Health, Kolkata, India
Sudip Saha
Department of Paediatrics, Chittaranjan Seva Sadan College of Obstetrics Gynecology and Child Health, Kolkata, India
Partha Pratim Pal
Department of Paediatrics, Chittaranjan Seva Sadan College of Obstetrics Gynecology and Child Health, Kolkata, India
Aparajita Bera
Department of Paediatrics, Chittaranjan Seva Sadan College of Obstetrics Gynecology and Child Health, Kolkata, India
Shyama Birua
Department of Paediatrics, Chittaranjan Seva Sadan College of Obstetrics Gynecology and Child Health, Kolkata, India
Keywords
endocrinopathies, serum ferritin, Thalassemia major