THE EFFECT OF REGULAR BLOOD TRANSFUSION AND DESFERAL USE IN PREVENTING OF HYPOTHYROIDISM IN ADOLESCENT MAJOR THALASSEMIC PATIENTS

Hypothyroidism is an important endocrine complication of major thalassemia. It should be prevented because of its effects on patients’ growth and development. The aim of this study was to determine the effect of regular blood transfusion and desferal use in preventing of such complications. An observational, cross-sectional study was conducted on 185 major thalassemic adolescents in Hazrat Ali-Asghar Hospital. For regular blood transfusion, the Hb level and for regular desferal use, the ferritin level was detected. The patients’ age ranged from 12-20 years old with a mean of 14.61. One hundred and twelve patients (60%) were male and 73(40%) were female. Among the patients, 161(87%) had no complication and 24 (13%) suffered from hypothyroidism. This study covered a period of five years starting in March 1995 and ending in March 2000. The results of this study showed that 8% of hypothyroid patients hadHb level more than 10 g/dl. Also 30% of other thalassemic patients had Hb level more than 10 g/dl namely good transfusion compliance, (P value = 0.08). The study also showed that 21% of hypothyroid patients and 52% of other thalassemic patients had ferritin level less than 1500 ng/ml, namely good chelation compliance, (P value = 0.004). All the patients in this study had primary hypothyroidism and all of them had subcutaneous or intravenous injection of desferal. This study suggests that therapy of patients with major thalassemia should be planned in a way that the Hb level be kept over 10 g/dl and Ferritin level at less than 1500 ng/ml.