Effect of Iron Overload and Lipid Peroxidation on Hyroid Function in Iraqi Patients with ß- Thalassemia
Keywords:
beta-thalassemia, serum ferritin, MDA, hypothyroidismAbstract
Background: Iron overload due to blood multi transfusion can lead to thyroid dysfunction in beta-thalassemia major patients with increased cell damage due to imbalance of the redox system .An iron chelation is essential to prevent the deposition of iron in tissues and glands such as thyroid.
Objectives: to investigate the reflections of blood transfusion induced iron overload and lipid peroxidation on the status of thyroid functions in Iraqi children and young adults with beta-thalassemia major.
Methods: Blood samples were taken from 60 males & females with Beta thalassemic major (BTM ) with age ranged (3-32) years. An automated hematology analyzer (Sysmex) was used in the measurements of blood Hb concentration and red cell indices. malondialdehyde(MDA), serum iron and total iron binding capacity (TIBC) concentration were determined spectrophotometrically . The triiodotyronine (T3) ,Free T3,thyroxine (T4),Free T4 ,thyroid stimulating hormone (TSH) and Serum Ferritin concentrations were assayed by an ELISA method .
Results : There were  low mean concentration  of  Hb  in  BTM  and a significant  increase in serum ferritin and MDA  in  comparison  with  the  normal  corresponding  values  for the  control  . Hypothyroidism was found in 12 (20%) out of 60 patients with BT major, (12%) were having subclinical hypothyroidism and five (8%) suffer from primary hypothyroidism with a positive a correlation of serum ferritin concentration with both MDA and number of monthly transfused blood units.
Conclusion: Transfusion associated iron overload play an effect on lipid peroxidation and the thyroid hormones (T3, T4) metabolism which leads to a disturbance in thyroid hormones secretion as consequences of thyroid dysfunction.
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References
Higgs D.R. -Gene Regulation In Hematopoiesis: New Lessons from Thalassemia. Hematology: pp1 -13. 2004
Hoffbrand A.V., Catovsky D. and Tuddenham E. Postgraduate Haematology 3rd ed. Blackwell Publishing, Oxford, , pp 85-103. 2005
Lichtman M.A., Beutler E., Kipps T.J., and Williams W.J., Williams Manual of Hematology 6thed. McGraw-Hill, New York, , pp 91-98. 2003
Thein S.L., Hesketh C, Wallace R.B. and Weatherall D.J. - The molecular basis of thalassemia major and thalassemia intermedia in Asian Indians : application to prenatal British journal of haematology, 70: pp 225-231. 1988,
Thong M,Tan J.A,Tan K.L. and Yap S.F.-charctrization of β-Globin Gene Mutation in Malaysian children :a strategy for The Control of β-Thalassemia in Developing country.Journal of Tropical Pediatrics, , 51: pp326-333. 2005
Wondisford F.E.Magner J.A.and Weintraub B.D. chemistry and biosynthesis of thyrotropin. The thyroid, 7th ed. Philadliphia: Lippincott-Raven, , 190: pp 207. 1996
Shamshirsaz A. A., M. R. Bekheirnia, M. Kamgar, N. Pourzahedgilani, N. Bouzari, M. Habibzadeh, R. Hashemi1, A. A. Shamshirsaz, S. Aghakhani, H. Homayoun and B. Larijani. Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran. BMC Endocrine Disorders, 3: pp 1-6. 2003
Magro S., Puzzanio P., Consarino C., Galati MC, Morgione S., Porcelli D., Grimaldi S., Tancre D., Arcuri V., De Santis V: Hypothyroidism in patients with thalassemia syndromes. Acta Haemato, , 84: pp 72-6. 1990
Green ST, Ng JP, Chan-Lam D: Insulin dependent diabetes mellitus, myasthenia gravis, pernicious anemia, autoimmune thyroiditis and autoimmune adrenalitis in a single patient. Scott Med J 33: pp 213, 1988.
Rund D, Rachmilewitz E., Beta–thalassemia. N Engl J Med, 353: pp 1135 - 1146. , 2005
Hohenwallner W., Wiesinger K., Wimmer E. The reticulocytes: automatic counting, indication and interpretation. Sysmex J Int.;2: pp 120-135. 1992
Richard A. Goldsby. Thomas, Antigen-Antibody interactions, principles and applications, Kuby immunology; Chapter 6, pages 147-150. , 2007
David McAuley, Pharm.D. , Basic Skills in Interpreting Laboratory Data, 2012.
Young ds, effect of drugs and disease on clinical lab 4th edition, 2001.
Deighton N, Hider RC: Intracellular low molecular weight iron. Biochem Soc, Trans, 17: pp 490. 1989,
Fong, K.L., McCay, P.B., and Poyer, J.L.; J. Biol. Chem., evidanc that peroxidation of lysosome membrane in intiated by hydroxyl free radicals production during flavine enzyme activity, , 248: pp 7792. 1973
Irshaid F. and Mansi K. Status of Thyroid Function and Iron Overload in Adolescents and Young Adults with Beta- Thalassemia Major Treated with Deferoxamine in Jordan. International Journal of Biological and Life Sciences 7:1: pp 47-52. 2011
Karamifar H, Karimi M, Amirhakimi GH, Badiei M. Endocrine function inthalassemia intermedia. IJBS; 2: pp 236-240. 2006
Brechot C. Hepatitis virus C infection. In: New Trends in Therapy for Hemoglobinopathies and Thalassemias. Paris, , pp 19-22, 1994.
Bassett ML, Halliday JW, Powell LW. Value of hepatic iron measurements in early hemochromatosis and determination of the critical iron level associated with fibrosis. Hepatology; 6: pp 24-9. 1986
Bacon BR. Causes of iron overload. N Engl J Med; 326: pp 126-7. 1992.
Ra’id M. Hannun. Al-Salih , Mohammed A. Awda Ali M. Ali AL-Azeirjawy, Oxidant and Antioxidant Status in Serum of Patients with beta-Thalassemia After and Before Blood Transfusion. Journal Of College Of Education: pp 302-326. , 2011
Subuh S. Al-Mudalal, Raad J. Musa, Najat Al-Duliami. Antioxidant Status In Thalassemic Patients, Iraqi J Med Sci, Vol. 4: pp 38-44. 2005;
Naithani, R. , Chandra, J. , Bhattacharjee, J. , Verma, P. , and Narayan, Sh., Pediatr. Blood Cancer, , 46: pp 780. 2006
Owayes M. Al-Hassany. Lipid Peroxidation, Antioxidant Status and some Blood Components in β-Thalassemia. Jou. Raf. Sci., ,Vol. 21, pp. 24-32. 2010
Pirinççioğlu A. Gözü,Turgay Deniz,; Deniz Gökalp, Nurcan Beyazıt, Kenan Haspolat, and Murat Söker. Assessment of Thyroid Function in Children Aged 1-13 Years with Beta-Thalassemia Major. Iranian Journal of Pediatrics; 21: pp 77-82. , 2011
Kallistheni Farmaki, Hypothyroidism in Thalassemia, Hypothyroidism - Influences and Treatments, Dr. Drahomira Springer (Ed.), ISSN: 978-953-51-0021-8. 2012,
Mehrvar A , Azarkeivan A , Saberi Nejad, Mehrvar N, Faranoosh M, Vosoogh P. Prevalence of hypothyroidism and hypoparathyroidism in Iran. Blood J 5(1): pp 53-59. 2008
De Sanctis V, De Sanctis E, Ricchieri P, Gubellini E, Gilli G, Gamberini MR, Mild subclinical hypothyroidism in thalassaemia major: prevalence, multigated radionuclide test, clinical and laboratory long-term follow-up study, Pediatr Endocrinol, , Vol.6, pp. 174-80. 2008.
De Sanctis V, Tangerini A, testa MR, et al. Final Height and endodcrine function in thalassemia intermedia. Endocrinol Metab. 11: pp 965-971, 1998.
Sabato AR, De Sanctis V, Atti G, et al. Primary hypothyroidism and the low T3 syndrome. Arch Dis Child,;58:pp120-127. 1983.
Alireza Abdullah et al.: Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran. BMC Endocrinol Disord.,3: pp 4, 2003.
Hashemi.A1 MD, Ordooei.M2 MD, Golestan.M3 MD, Akhavan Ghalibaf. M4 MD, Mahmoudabadi. F4 BSc, Arefinia. M4 BSc, Amanat. M4 BSc, Purshamsi.F4 BSc, Afkhami.M4 MD, Hypothyroidism and Serum Ferritin Level in Patients with Major ß Thalassemia, 2011.
Malik SA, Syed S, Ahmed N. Frequency of hypothyroidism in patients of beta-thalassemia. Pak I Med Assoc; 60: pp 17-29. 2010
Klein I, Danzi S., Thyroid disease and the heart. Circulation, 2007, vol. 116, pp. 1725.
Bernal J., Action of thyroid hormone in brain, Journal of Endocrinological Investigation, , Vol. 25, pp268–288. 2002.
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