Echocardiography in Transfusion Dependent Beta Thalassaemia Major Egyptian Children: Correlation with Thyroid Function Status and Ferritin Level
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 4
Abstract
ABSTRACT Introduction: Iron-mediated cardiomyopathy is leading cause of death in β-thalassaemia (βTM). Thyroid dysfunction maybe associated with cardiac dysfunctions. Early detection of cardiac-function impairment can help in preventing further cardiac damage by modifying disease progression and treatment. Aim: To assess cardiac function and echocardiography indices in transfusion dependent βTM children in Qena, Egypt and correlate findings with thyroid status and serum ferritin levels. Materials and Methods: This was a case-control study conducted on 40 transfusion dependent βTM cases aged from 6-12 years who were on regular follow-up in outpatient paediatric clinic in Qena university hospital between January 2016 and December 2016. Fifteen, age and sex-matched healthy children were included as a control group to investigate Left Ventricle (LV) diastolic and systolic function using echocardiography, and correlate findings with serum Thyroid Stimulating Hormone (TSH), free thyroxine (FT4), and serum ferritin. SPSS version 22 used for data analysis and Pearson correlation was used to explore the relationship between quantitative variables. All statistical tests were two tailed, and a p-value below 0.05 was considered statistically significant. Results: In children with βTM had a mean age 9.51 years (SD±3.26), (n=10, 25%) had hypothyroidism; primary (n=1, 2.5%), subclinical (n=5, 12.5%) and central (n=4, 10%). Cases had Left Ventricular Ejection Fraction percentage (LVEF%) of 67.68±7.04, ferritin level of 2617±1866 vs. 118±43 in control; (p-value=<0.001), Left Ventricular Dimensions at the End of Systole (LVESD) 40.63±6.17 vs. 36.53±4.82 in control; (p-value=0.025) and Left Ventricular Dimensions at the End of Diastole (LVEDD) was 25.40±4.83 vs. 22.60±3.54 in control; (p-value=0.046). Cases with impaired thyroid function had higher ferritin and lower EF%. Cases displayed left ventricular diastolic restrictive pattern with preserved left ventricular systolic function in echocardiogram. FT4 showed a negative correlation with TSH and myocardial performance index (LV Tei) while ferritin showed a positive correlation with TSH, LVEDD and LVESD. Conclusion: Periodic evaluation of thyroid and cardiac functions and thyroxine replacement maybe considered in cases with iron overload, subclinical hypothyroidism and poor response to chelation therapy.
Authors and Affiliations
Hanan Mahmoud Fayed, Eman Ahmed Abdel Mawgood, Heba Mohammed Qubaisy
Keywords
Related Articles
- EP ID EP523864
- DOI 10.7860/JCDR/2018/32790.11365
- Views 38
- Downloads 0
Correlation of Vitamin D3 Levels and SCORAD Index in Atopic Dermatits: A Case Control Study
Introduction: Atopic Dermatitis (AD) is a common chronic inflammatory condition characterized clinically by pruritus and eczematous lesions. An inverse relationship has been suggested between serum 25-hydroxyvitamin D co...
Factors Associated with Tobacco Use in Female Subjects: A Study from Eastern India
ABSTRACT Introduction: Tobacco use among females is a rising public health problem. This is especially true in developing countries of South-east Asia. Certain factors like illiteracy, poverty and changing social norms a...
Odontogenic Fibroma Associated with an Impacted Tooth
Central Odontogenic Fibroma (COF) is an extremely rare benign tumour caused by proliferation of mature odontogenic mesenchyme that accounts for 0.1%-0.5% of all odontogenic tumours. It has a female predilection and often...
A Giant Hepatic Cyst Mimicking Echinococcosis
ABSTRACT Echinococcosis is a life-threatening disease for humans. It occurs all over the world. We report a case of large and complicated hepatic cyst mimicking the Echinococcosis. A 68-year-old female was referred with...
Chronic Unresolved Haematoma of Thigh with Acute Expansion- Emulating Neoplasm
Chronic haematoma formation and its acute expansion are rare in clinical scenario. Its clinical presentation may simulate to malignant soft tissue lesion. Usually they remain inactive for long time but sometimes shows su...