Haghpanah Sezaneh, Jelodari Shohreh, Karamifar Hammdollah, Saki Forough, Rahimi Rahil, De Sanctis Vincenzo, Dehbozorgian Javad, Karimi Mehran
Hematology Research Center, Shiraz University of Medical Sciences.
Department of Pediatrics, Shiraz University of Medical Sciences.
Acta Biomed. 2018 Mar 27;89(1):55-60. doi: 10.23750/abm.v89i1.5778.
Hypothyroidism is one the most complication due to iron overload in patients with β-thalassemia major (TM). On the other hand these patients are prone to Hepatitis C virus (HCV) infection that can cause thyroid dysfunction by itself or as the side effect of treatment with interferon (INF) or IFN plus ribavirin. The aim of this study is to evaluate the association of hypothyroidism with HCV positivity and serum ferritin levels in patients with TM.
In this cross-sectional study, 201 randomly selected patients with TM who were registered at the Thalassemia Clinic of a tertiary hospital in Shiraz, southern Iran were investigated. Thyroid function tests and serologic screening assays for HCV seropositivity (HCV Ab and HCV-RNA) were conducted for all patients.
Frequency of hypothyroidism was 22.9% including 19.9% subclinical hypothyroidism, 2% primary overt hypothyroidism and 1% central hypothyroidism. Eighty six patients (42.8%) were HCV Ab positive and 60 patients (29.9%) were HCV RNA positive. No significant relationship was found between hypothyroidism and HCV positivity or receiving IFN-α (P>0.05). Hypothyroidism showed a borderline significant association with high serum ferritin levels in TM patients (P=0.055).
Our results showed no significant association between hypothyroidism and HCV infection in TM patients. It seems that the main mechanism of hypothyroidism in our patients is iron overload; however, for better evaluation a larger multicenter study is recommended. Also due to the importance of consequences of HCV infection, more careful pre-transfusional screening of blood should be considered in TM patients.
甲状腺功能减退是重型β地中海贫血（TM）患者铁过载最常见的并发症之一。另一方面，这些患者易感染丙型肝炎病毒（HCV），该病毒本身或作为干扰素（INF）或INF加利巴韦林治疗的副作用可导致甲状腺功能障碍。本研究的目的是评估TM患者甲状腺功能减退与HCV阳性及血清铁蛋白水平之间的关联。
在这项横断面研究中，对伊朗南部设拉子一家三级医院地中海贫血诊所登记的201例随机选择的TM患者进行了调查。对所有患者进行甲状腺功能测试和HCV血清阳性（HCV抗体和HCV-RNA）的血清学筛查检测。
甲状腺功能减退的发生率为22.9%，包括19.9%的亚临床甲状腺功能减退、2%的原发性显性甲状腺功能减退和1%的中枢性甲状腺功能减退。86例患者（42.8%）HCV抗体阳性，60例患者（29.9%）HCV RNA阳性。甲状腺功能减退与HCV阳性或接受IFN-α之间未发现显著关系（P>0.05）。甲状腺功能减退与TM患者高血清铁蛋白水平之间存在临界显著关联（P=0.055）。
我们的结果显示TM患者甲状腺功能减退与HCV感染之间无显著关联。似乎我们患者甲状腺功能减退的主要机制是铁过载；然而，为了更好地评估，建议进行更大规模的多中心研究。此外，由于HCV感染后果的重要性，应考虑对TM患者进行更仔细地输血前血液筛查。
