Volume 20, Issue 3 (َAutumn 2023)                   bloodj 2023, 20(3): 214-224 | Back to browse issues page

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Foroughi Ardakan R, Hanachi P, Azarkeivan A, Arab Khazaeli A. ]nvestigating hypothyroidism in beta thalassemia patients receiving blood and determining its relationship with iron overload and iron removal treatment. bloodj 2023; 20 (3) :214-224
URL: http://bloodjournal.ir/article-1-1500-en.html
]nvestigating hypothyroidism in beta thalassemia patients receiving blood and determining its relationship with iron overload and iron removal treatment
R. Foroughi Ardakan , P. Hanachi * , A. Azarkeivan , A. Arab Khazaeli
Keywords: Key words: Hypothyroidism, Thalassemia, Iron Overload, Iron Chelating Agents
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Sci J Iran Blood Transfus Organ 2023;20 (3): 214-224
Orginal Article
 


Investigating hypothyroidism in beta thalassemia patients receiving blood and determining its relationship with iron overload and iron removal treatment

Foroughi Ardakan R.1, Hanachi P.1, Azarkeivan A.2, Arabkhazaeli A.2

1Faculty of Biological Sciences, Alzahra University, Tehran, Iran
2Blood Transfusion Research Center, High Institute of Research and Education in Transfusion Medicine, Tehran, Iran

Abstract
Background and Objectives
Blood transfusion in thalassemia patients has side effects such as endocrine iron overload. It is necessary to use iron chelators. The aim is to investigate the prevalence of hypothyroidism and its relationship with the level of iron overload and the results of the heart and liver MRI as a new method for diagnosing iron deposition, and iron removal treatment. Determining the factors affecting this complication can help prevent or improve it. 

Materials and Methods
This cross-sectional study was conducted on 232 beta-thalassemia major and intermedia patients of Tehran adult thalassemia clinic in the year 1400 who were selected by convenient sampling method. The comparison of the level of thyroid hormones and ferritin was done with Chi-squared, independent t, Mann-Whitney and Kruskal-Wallis tests by SPSS 26.

Results
The prevalence of hypothyroidism in patients with an average age of 40.79 ± 9.02 year was 27.6%. There was no significant relationship between hypothyroidism with ferritin levels  or heart and liver iron deposition. TSH level was significantly (p= 0.01) higher in men than women. Most of patients used combined iron chelators, but the type of drug was not significantly different.

Conclusions 
It seems that iron overload may be effective in hypothyroidism, but it does not necessarily lead to it. Despite the treatment of iron deficiency, this complication is still one of the main problems. It is suggested to consider the amount of iron load and iron removal treatment before and after the onset of hypothyroidism in future studies.

Key words: Hypothyroidism, Thalassemia, Iron Overload, Iron Chelating Agents








Received: 14 Jun  2023
Accepted:  9 Aug 2023



Correspondence: Hanachi P., PhD of Biochemistry. Associate  Professor  of  Faculty  of Biochemistry Unit, Fculty of Biological Sciences, Alzahra University.
Postal Code: 1916799553, Tehran, Iran. Tel: (+9821) 88044040; Fax: (+9821) 88035187
E-mail: p.hanachi@alzahra.ac.ir







 References:
  1. Azarkeivan A. Comprehensive package of medical services in thalassemia patients. 2nd ed. Ahvaz: Motabar; 2015. p. 27-42. [Persian]
  2. Atmakusuma TD, Kalwani R, Nasution SA, Rumende CM. Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients. Acta Med Indones 2021; 53(3): 291-8.
  3. Eshraghi P, Tamaddoni A, Zarifi K, Mohammadhasani A, Aminzadeh M. Thyroid function in major thalassemia patients: Is it related to height and chelation therapy? Caspian J Intern Med 2011; 2(1): 189-93.
  4. Cao A, Galanello R. Beta-thalassemia. Genetics in medicine: official journal of the American College of Medical Genetics 2010; 12(2): 61-76.
  5. Oikonomidou PR, and Rivella S. What can we learn from ineffective erythropoiesis in thalassemia? Blood Rev 2018; 32(2): 130-43.
  6. Motta I, Bou-Fakhredin R, Taher AT and Cappellini MD. Beta Thalassemia: New Therapeutic Options beyond Transfusion and Iron Chelation. Drugs 2020; 80(11): 1053-63.
  7. Shah FT, Porter JB, Sadasivam N, Kaya B, Moon JC, Velangi M, Ako E & Pancham S. Guidelines for the monitoring and management of iron overload in patients with haemoglobinopathies and rare anaemias. Br J Haematol 2022; 196(2): 336-50.
  8. Sehat R, Shahabi Satalsar E, Hanachi P. Correlation between iron status, TIBC and ferritin and thyroid hormone levels in patients referred to the medical diagnosis laboratory of Shourideh Hospital in Mashhad. Journal of Paramedical Faculty of Tehran University of Medical Sciences (Piyavard Salamat) 2018; 13(2): 133-40. [Article in Farsi]
  9. Al-Moshary M, Imtiaz N, Al-Mussaed E, Khan A, Ahmad S and Albqami S. Clinical and Biochemical Assessment of Liver Function Test and Its Correlation with Serum Ferritin Levels  in    Transfusion-dependent Thalassemia Patients. Cureus 2020; 12(4): e7574.
  10. Yousaf HMS, Sarfraz L, Hussain ST. Prevalence of Hypothyroidism in Patients of Beta Thalassemia Receiving Blood Transfusion. JSZMC 2018; 9(3): 1453-55.
  11. Ali S, Mumtaz S, Shakir HA, Khan M, Tahir HM, Mumtaz S, Mughal TA, Hassan A, Kazmi SAR, Sadia, Irfan M and Khan MA. Current status of beta-thalassemia and its treatment strategies. Mol Genet Genomic Med  2021; 9(12): e1788.
  12. Karimi M, Zarei T, Haghpanah S, Azarkeivan A, Kattamis C, Ladis V, et al. Evaluation of endocrine complications in beta-thalassemia intermedia (β-TI): a cross-sectional multicenter study. Endocrine 2020; 69(1): 220-7.
  13. Taher AT & Saliba AN. Iron overload in thalassemia: different  organs  at   different rates. Hematology 2017; (1): 265-71.
  14. Zarghami P. Examining the frequency of variants c.-153C > T and c.-582A > G in the gene encoding the hormone hepcidin and its relationship with iron accumulation in thalassemia patients receiving blood referred to Zafar thalassemia clinic. [Dissertation]. [Tehran]: Transfusion Medicine Institute; 2017. p. 88.
  15. Jabbar Kadhum S. The Prevalence of Hypothyroidism among Patients with Beta-Thalassemia Major, Western Iraq. Iraqi Postgraduate Medical Journal 2018; 17(2): 170-4.
  16. Malik S, Ahmed N. Complications in transfusiondependent patients of B-thalasemia major. Pak J Med Sci 2009; 25(4): 678-82.
  17. Kashanchi Langroudi M, Abdul Rahim Porheravi H. Prevalence of diabetes, hypothyroidism and hypoparathyroidism in thalassemia major patients Referred to Shahid Dr. Mohammad Javad Bahnar Hospital in Karaj. Blood Research Quarterly 2012; 9(4): 422-8. [Article in Farsi]
  18. Mehrvar A, Azarkivan A, Sabrinejad J, Mehrvar N,
    Franoush M, Vathouq P. Hypothyroid and hypoparathyroid problems in patients with beta thalassemia Referred to adult thalassemia center in 1383  to  1384.  Blood  Research Quarterly  2008; 5(1): 53-9. [Article in Farsi]
  19. Cappellini MD, Cohen A, Porter J, Taher, A & Viprakasit, V. [Guidelines for the management of transfusion dependent thalassemia (TDT)] 3rd ed. Cyprus: Thalassemia International Federation; 2014. p. 120.
  20. Lakzaei H, Shahdadi H, Abdolahi Mohamad A, Dehmordeh M. Investigation of serum ferritin level in patients with thalassemia major in the thalassemia department of Amiral Mominin Hospital in Zabul city in 2011. Research Quarterly of Zabul University of Medical Sciences 2013;  5(1): 27-31. [Article in Farsi]
  21. Tabatabaie SM, Abdollah Shamshirsaz A, Bakhirnia MR, Kamghar M, Bozari N, Pourzahedeh Gilani N, et al. Metabolic and endocrinologic complications in beta-thalassemia major. A Multicenter study in Tehran. Iran South Med 2002; 1: 63-72.
  22. Pignatti C, Rugollotto S, De Stefano P, Zhao H, Forni G, Piga A, et al. Survival and complication in patients with beta thalassemia major. Heamatologica 2004; 89(11): 87-93.
  23. Pinto VM and Forni GL. Management of Iron Overload in Beta-Thalassemia Patients: Clinical Practice Update Based on Case Series. Int J Mol Sci 2020; 21(22): 8771.




















 
Type of Study: Research | Subject: Endocrinology
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