HIGH PREVALENCE OF CENTRAL HYPOTHYROIDISM IN ADULT PATIENTS WITH β-THALASSEMIA MAJOR

01 September 2013

De Sanctis V, Soliman A, Candini G, Campisi S, Anastasi S, Yassin M.

Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy; Department of Pediatrics, Hamad Medical Center (HMC), Doha, Qatar; Department of Medical Physics, St.Anna Hospital, Ferrara, Italy; Unit for the Diagnosis and Treatment of Thalassaemia,Umberto I Hospital, Siracusa, Italy; Department of Thalassaemia, Garibaldi Hospital, Catania, Italy; Department of Hematology, Hamad Medical Center (HMC), Doha, Qatar.

Abstract

The commonest form of thyroid dysfunction seen in subjects with TM is primary hypothyroidism due to abnormalities of the thyroid gland. Central hypothyroidism (CH) has been reported as an uncommon clinical entity in TM patients although the anterior pituitary gland is particularly sensitive to free radical oxidative stresses. Diagnosis is usually made on a biochemical basis showing low circulating concentrations of thyroid hormone associated with an inappropriately low TSH levels. The diagnosis is not clinically obvious and a basal normal TSH level does not exclude the diagnosis of CH. Therefore, it is important that clinicians accurately interpret thyroid function tests. In TM patients, CH prevalence differs at different ages is unknown and it is not easy to diagnose because most of the symptoms of CH are non specific and are frequently attributed to anaemia or other associated complications. We performed a cross-sectional analysis on a large database using the clinical records of our TM patients to explore the prevalence of CH in prepubertal (patients; 13 males) peripubertal (between 11 and 16 years: 9 patients; 3 males), and pubertal TM subjects (>16 years: 305 patients; 164 males). Central hypothyroidism was present in 26 (7,6%) TM patients. Their mean age was 29.9±8.4 years, 14 (53.8%) were males and 12 (46.1%) were females. The prevalence of CH was 6% in patients with a chronological age below 21 years and 7.9% in those above 21 years. Clinicians should be alert for the diagnosis of CH through accurate interpretation of thyroid function tests. We recommend L-thyroxine therapy if the level of FT4 is consistently low provided that the patient has normal cortisol levels.

PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/24099820

HIGH PREVALENCE OF CENTRAL HYPOTHYROIDISM IN ADULT PATIENTS WITH β-THALASSEMIA MAJOR

Categories

Last posts

Initial Clinical Evaluation

Neurally mediated syncope starting ...

Regional Congress A.R.C.A. ...

THE EQUALITY PROJECT

Other posts from the same category

Neurally mediated syncope starting in old age does not appear to be unique to humans: new perspective

Initial Clinical Evaluation

THE EQUALITY PROJECT

EQUALITY PROJECT, THE FOURTH MAGAZINE

NEW ARTICLE BY DR. ALBONI ON THE HEART MAGAZINE

EQUALITY PROJECT, THE THIRD MAGAZINE

EQUALITY PROJECT, THE SECOND MAGAZINE

PROJECT EQUALITY, THE FIRST MAGAZINE

NEW PUBLICATION BY DR. ALBONI P. AND ALBONI M.

NEW ARTICLE PROF. ALBONI ON THE ITALIAN CARDIOLOGY JOURNAL

NEW SCIENTIFIC PUBLICATION BY DR. ALBONI

NEW PUBLICATION BY DR. ALBONI ON THE ITALIAN CARDIOLOGY JOURNAL

Book your visit online