A cross-sectional observational study on the association of serum ferritin with growth and thyroid profile in transfusion-dependent β-thalassemia patients.
Annotatsiya
Background: Transfusion-dependent β-thalassemia (TDT) is associated with progressive iron overload due to repeated blood transfusions. Excess iron deposition, reflected by elevated serum ferritin levels, contributes significantly to endocrine complications, particularly growth impairment and thyroid dysfunction, which remain under-recognized in routine clinical care. Aim: To assess the association of serum ferritin levels with growth parameters and thyroid profile in transfusion-dependent β-thalassemia patients. Methods: This hospital-based cross-sectional observational study was conducted in the Department of Paediatrics, M.R. Bangur Hospital, Kolkata, from August 2017 to April 2019. Seventy-five transfusion-dependent children (≤12 years) with β-thalassemia major or HbE/β-thalassemia were enrolled using simple random sampling. Serum ferritin, thyroid-stimulating hormone (TSH), and free thyroxine (fT4) were measured using electrochemiluminescence immunoassay. Anthropometric parameters (height and weight) were assessed and interpreted using CDC growth charts. Statistical analysis was performed using Epi-Info 7.2.2.2, with p < 0.05 considered significant. Results: Of the 75 children studied, 50.7% were males and 49.3% females; 56% had β-thalassemia major, and 44% had HbE/β-thalassemia. Hypothyroidism was detected in 10.7% of patients, predominantly subclinical. Low fT4 was observed in 5.3%, while elevated TSH was noted in 10.7%. Growth assessment showed that 37.3% of children were underweight and 9.3% were stunted. Mean serum ferritin levels were markedly elevated (overall mean ≈1595 ng/mL), with no significant gender difference. Conclusion: Thyroid dysfunction, particularly subclinical hypothyroidism, and growth impairment are common in transfusion-dependent β-thalassemia and are associated with elevated serum ferritin levels. Recommendations: Regular monitoring of serum ferritin, thyroid function, and growth parameters should be integrated into the routine follow-up of TDT patients. Early detection of endocrine dysfunction and optimization of iron chelation therapy are essential to reduce long-term morbidity and improve quality of life.