Endocrine Abstracts

Introduction: Hypothyroidism is the most common endocrine pathology during Major Beta Thalassemia (MBT). The geographic area is considered a factor in establishing the prevalence and form of hypothyroidism in MBT. We have tried through this study to establish features and determinants of hypothyroidism in Algeria.

Patients and methods: Twenty patients middle-aged 27 years (20–46 years) (10 males/10 Females) hospitalized in Pierre Marie Curie Center, Hematology unit, Algiers. All patients have been tested for thyroid hormones levels: TSH/FT4/FT3. Results have been correlated with ferritin and hemoglobin levels, the type of chelation (Deferoxamine/Deferasirox) as well as the viral serology.

Results: The prevalence of hypothyroidism is 25%. In 15% it is a subclinical hypothyroidism (1M/2F) who have benefited from antibody dosing (Ab TPO, Ab TG), while 10% have a central hypothyroidism, it is about two sisters without statural or weight delay having a gonadotropic deficit among them one died by hypersplenism having refused the splenectomy. No correlation was noted between ferritin and TSH (P: −0.06) nor FT4 (P: −0.05). Neither the Beta thalassemia duration nor the degree of anemia nor the type of chelator nor hyperferitemia appears to be risk factors for hypothyroidism with respectively Odds ratio (0.16/0.23/0.73/0.73). Subjects with viral hepatitis are more exposed, but not significantly, to hypothyroidism regardless of its form compared to unaffected individuals (odds ratio: 1.67).

Conclusion: In this sample of the North African MBT form, hypothyroidism seems to be heterogeneous between borderline primary hypothyroidism and the central form rarely described in the published series of the South European MBT, which demonstrates the main role of the geographical factor. Furthermore, an association of central and peripheral form of hypothyroidism in the same patient is not to eliminate. The treatment of subclinical hypothyroidism is often necessary especially in patients inadequately controlled under chelation treatment which are at high cardiovascular risk by iron overload.