Comparison of Thyroid Function and Chelation Therapy Duration between Deferiprone and Deferasirox in Transfusion-Dependent Children with Beta Thalassemia at Ulin Banjarmasin General Hospital

Abstract

Aims: Hypothyroidism is the second most frequent endocrine complication after hypogonadism in thalassemia patients. Investigate the relationship between the duration of deferiprone and deferasirox therapy, patient age, and thyroid function in β-thalassemia major patients. Study Design: This is a observational analytical research with a cross-sectional design. Place and Duration of Study: Department of Pediatric Medicine in Ulin Regional General Hospital between January 2022 and July 2024. Methodology: Patient baseline and laboratory data, including hemoglobin, ferritin, TSH, and fT4 levels, were collected from medical records of both outpatient and inpatient subjects. The study included children aged 2–18 years with beta-thalassemia major who had received oral deferiprone and deferasirox therapy for at least one year, with sampling conducted using a total population approach. Data analysis was performed using SPSS version 23.0, applying Fisher’s exact test to assess the relationship between deferiprone therapy duration and thyroid function at a 95% confidence level. Results: The study included 60 participants, with an average age of 7.9 ± 4.1 years; 61.7% were male. The mean serum ferritin level was 5291.86 ± 2664.37 ng/mL, and the mean hemoglobin level was 8.39 ± 1.32 g/dL. Most patients (68.3%) had received iron chelation therapy for 1–10 years, with deferiprone being the most common agent (61.7%). Thyroid function analysis showed 96.6% were euthyroid, while 3.4% had subclinical hypothyroidism. No significant differences in FT4 and TSH levels were found between different age groups or between those receiving deferiprone or deferasirox for ≤10 or >10 years, indicating that thyroid function remained within normal limits across all groups. Conclusion: Most beta-thalassemia major patients in this study maintained normal thyroid function, with a low prevalence of subclinical hypothyroidism. No significant correlation was observed between age, deferiprone and deferasirox therapy duration, and thyroid function. Further research is needed to identify additional risk factors and optimize iron chelation therapy for better thyroid health in these patients.