Volume 6, Issue 4 (11-2016)                   Iran J Ped Hematol Oncol 2016, 6(4): 261-276 | Back to browse issues page

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Department of Biostatistics, Psychosocial Injuries Research Center, Ilam University of Medical Sciences، Ilam, Iran
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Abstract

The present study aimed to determine the prevalence of hypothyroidism, hypoparathyroidism and the frequency of regular chelation therapy in patients with thalassemia major in Iran. Searching process was performed by two independent  researchers using valid keywords in the national and international database, including: Magiran, Iranmedex, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library and google scholar search engine. All studies were searched until 2016 with no time limit. All articles met inclusion criteria were evaluated and the data were analyzed by using SATA Software Ver.11.1. Twenty-seven studies about hypothyroidism (sample size of 4851, the mean age of 16.36±5.5) and 19 studies related to hypoparathyroidism (sample size of 3219, the mean age of 17.44±6.5) were examined. The prevalence of hypothyroidism was calculated 5.7% (95% CI: 4.7-6.8) in patients with thalassemia major in Iran (P=0.000; I2 index=93.9%). The prevalence of overt and subclinical hypothyroidism was estimated 3.1% (95% CI: 1-4.7) and 6.7% (95% CI: 3.3-10), respectively. The prevalence of hypoparathyroidism was calculated 10% (95% CI: 7-12) in patients with thalassemia major in Iran. In reviewing 5 studies, the frequency of regular chelation therapy was estimated 54.6% (95% CI: 28-81.2) in these patients. The prevalence of hypothyroidism and hypoparathyroidism is high in patients with thalassemia major in Iran. Thus, new planning and supervising seem to be essential to minimize endocrine complications in these patients. There is no connection between serum ferritin level and developing hypoparathyroidism. A high percent of Iranian patients with thalassemia major perform the chelation therapy irregularly. It's been recommended to adopt the necessary measures such as educating and enhancing awareness of the patients about its complications.

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Type of Study: Research | Subject: Heart
Received: 2015/05/18 | Accepted: 2015/07/28 | Published: 2016/10/30

References
1. Benz EJ. Hemoglobinopathies disorder. In: KasperDennis L, Braunwald, Fauci, Hauser, Longo, Jameson. Harrison's Principles of internal medicine. 16th Edition, Mc Grow Hill: USA, 2005. [Article]
2. Shamshirsaz AA, Bekheirnia MR, Kamgar M, Pourzahedgilani N, Bouzari N, Habibzadeh M, et al. Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran. BMC endocrine disorders 2003; 12; 3(1): 4. [Article]
3. Al-Gazali L, Hamamy H, Al-Arrayad S. Genetic disorders in the Arab world. Bmj 2006; 21; 333(7573):831-4. [Article]
4. Saffari F, Mahyar A, Jalilolgadr S. Endocrine and metabolic disorders in beta-thalassemiamajor patients. Caspian journal of internal medicine 2012; 3(3):466-72. [Article]
5. Rabbani A, Azar Keiwan A, Farhadi Langeroudi M, Korosdari Gh.H. Clinical evaluation of 413 Thalassemic patients. Tehran Univ Med J 2000; 58: 35-41. [Article]
6. Kashanchi Langarodi M, Abdolrahim Poorheravi H. Prevalence of diabetes, hypothyroidism and hypoparathyroidism in thalassemia patients in Shahid Bahonar Hospital, Karaj. Sci J Iran Blood Transfus Organ. 2013; 9(4); 422-428. [Article]
7. Azami M, Sayemiri K. Prevalence of Diabetes Mellitus in Iranian Patients with Thalassemia Major: A Systematic Review and Meta-Analysis. J Mazandaran Univ Med Sci 2016; 26(141):192-204. [Article]
8. Lanzkowsky P. Manual of Pediatric Hematology and Oncology; 4th ed., Philadelphia Elsevier, 2005; PP 181-90. [Article]
9. Company F, Rezaei A, Mozaffari R. Evaluation of cardiac involvement in patients with thalassemia major and thalassemia intermedia. Sci J Kurdistan Univ Med Sci 2008; 13(2): 1-9. [Article]
10. Lukens JN. The thalassemia and related disorders. In: Jonatha W, Pine Jr. Wintrobe's clinical hematology. 10th. USA. Williams and Wilkins 1999; 1405-49. [Article]
11. Alfenerio A, Motargem M, Abrishami D. About Thalassemia. Tehran, Nozhat, 2005, 46-47. [Article]
12. Sabato AR, de Sanctis V, Atti G, Capra L, Bagni B, Vullo C. Primary hypothyroidism and the low T3 syndrome in thalassaemia major. Archives of disease in childhood 1983; 58(2): 120-7. [Article]
13. Soliman AT, Al Yafei F, Al-Naimi L, Almarri N, Sabt A, Yassin M, et al. Longitudinal study on thyroid function in patients with thalassemia major: High incidence of central hypothyroidism by 18 years. Indian journal of endocrinology and metabolism 2013; 17(6): 1090-5. [Article]
14. Michael R.Hemoglobinopathies, Chapter 462 in: Richard E, Behrman R, Kliegman R(eds). Nelson textbook of pediatrics, 18th ed. Philadelphia WB saunders, co. 2007; 2033-2037. [Article] [DOI]
15. Yavari. Epidemiology textbook of prevalent diseases in Iran. Nasher Publication Gap 2013-2014; 9(5): 1151-4. [Article]
16. Ferrara M, Matarese SM, Francese M, Borrelli B, Coppola A, Coppola L, et al. Effect of VDR polymorphisms on growth and bone mineral density in homozygous beta thalassaemia. British journal of haematology 2002; 117(2): 436-40. [Article]
17. Al-Akhras A, Badr M, El-Safy U, Kohne E, Hassan T, Abdelrahman H, et al. Impact of genotype on endocrinal complications in beta-thalassemia patients. Biomedical reports 2016; 4(6): 728-36. [Article]
18. Azami M, Khataee M, Bigam bigdeli-shamlo M, Abasalizadeh F, Abasalizadeh Sh, et al. Prevalence and Risk Factors of Hepatitis B Infection in Pregnant Women of Iran: A Systematic Review and Meta-Analysis. IJOGI 2016; 19(18): 17-30. [Article]
19. Sayehmiri K, Azami M, Nikpey S, Borji M, Sayehmiri F. Hepatitis B Vaccination Coverage in Health Personnel of Iran: A Systematic Review and Meta-Analysis Study. irje. 2015; 11 (3):1-10. [Article]
20. Mehrvar A, Azarkeivan A, saberi Nejad J, Mehran N, Faranoosh M, Vosoogh P. Prevalence of hypothyroidism and hypoparathyroidism in patients with ß thalassemia in Iran . Sci J Iran Blood Transfus Organ 2008; 5(1): 53-59. [Article]
21. Mehrvar A, Azarkeivan A, saberi Nejad J, Mehran N, Faranoosh M, Vosoogh P. Prevalence of hypothyroidism and hypoparathyroidism in patients with ß thalassemia in Iran . Sci J Iran Blood Transfus Organ 2008; 5(1): 53-59. [Article]
22. Najafipour F, Sarisorkhabi R, Bahrami A, Zareizadeh M, Ghoddousi K, Aghamohamazadeh N, et al . Evaluation of Endocrine Disorders in Patients with Thalassemia Major. Iran J Endocrinol Metab 2008; 10(1): 35-43. [Article]
23. Zndehbad A, Beigom Mirbehbahani N. Assessment of the Relation between Hypothyroidism & Serum Level of Ferritin in ß Thalassemia Patients Med J Mashad Univ Med Sci 2009; 52(3): 123-128. [Article]
24. Zandian Kh, Eshagh Hossaini K, Riahi K. A study of prevalence of hypothyroidism in B-thalassemia major in Ahvaz Shafa hospital. Sci Med J Ahwaz Jundishapur Univ Med Sci 2009; 8(3): 272-290. [Article]
25. Rostami P, Hatami G, Shirkani A. Endocrine complications in patients with major β-thalassemia. ISMJ. 2011; 14(4): 240-245. [Article]
26. Vahidi A A, Parvaresh S, Torabi Nejad M, Ahmadi A, Mohammadi R. The incidence of complications in patients with beta-thalassemia major centers Kerman special diseases during the second half of 1387. J Kerman Univ Med Sci 2011; 18(3): 318-329. [Article]
27. Mostafavi H, Afkhamizadeh M, Rezvanfar M. Endocrine disorders in patients with thalassemia major. Iran J Endocrinol Metab. 2005; 7(2): 143-147. [Article]
28. Chhkndy T. Evaluation of thyroid and parathyroid function in patients with thalassemia major. J Birjand Univ Med Sci 2004; 11(2): 9-15. [Article]
29. Hadaegh F, Zaree Sh, Tohidi M, Safa O, Mahori Kh. Pituitary-thyroid axis function and metabolism of calcium and phosphorus in patients with thalassemia major Hormozgan province. Hormozgan Univ Med J. 2002; 6(2): 1-6. [Article]
30. Jalali Farahani F, Zolgaghari S, Talebian A, Azarkeivan A, Maghsudlu M, Sarmadi M, et al . Prevalence of thyroid dysfunction and relevant risk factors among thalassmia patients having referred to Iranian Blood Transfusion Organization Clinical Laboratory of Tehran. Sci J Iran Blood Transfus Organ 2009; 6(1): 59-64. [Article]
31. Razavi Z, Bazmamoun H, Sadegh Saba M. The frequency of hypoparathyroidism in patients with Beta-thalassemia in Hamadan - Iran. J Gorgan Uni Med Sci 2009; 10(4): 29-33. [Article]
32. Ansari H, Tabatabai, H. Study of factors in major beta thalassemia Complications in patients admitted to Dshahid Dastgheib hospital in Shiraz, Iran (2004-5). Sabzevar Univ Med J 2007; 14(1): 62-72. [Article]
33. Karami H, Vahid-Shahi K, Kowsarian M, Abaskhaniyan A, Parvin-nezhad N, Ehteshami S et al . Evaluation of ocular defects and its relevant factors in patients with beta thalassemia major in Sari Boo Ali Sina hospital, (2006-2008). Yafteh 2009; 10(4): 20-27. [Article]
34. Soheili Khah S, Eslami S. Endocrine disorders in Thalassemia major in Yazd Blood Bank in 1998. Journal of Shahid Sadoughi University of Medical Sciences and Health Services 2000; 8(1): 11-7. [Article]
35. Mahdavi Anari F, Ahmadian A, Haghshenas Z, Alawi Yazdi Z. Comparison of the frequency of four endocrine disorders in patients with thalassemia major referred to thalassemia clinic of Tehran Imam Khomeini Hospital in 2000. [Dissertation]. Tehran: Tehran University of Medical Sciences; 2000. [Article]
36. Seyedi J, Vahidi AA, Kashanian Moshtaghi Gh, Shahbazian N. Assessment of thyroid dysfunction in patients with thalassemia referred to number one hospital of Kerman University of Medical Sciences in 1998. [Dissertation]. Kerman: Kerman University of Medical Sciences; 1998. [Article]
37. Nasiri MR, Bastanhagh MH, Mohajer S, Khodabaneh A. Evaluation of thyroid dysfunction in patients with beta thalassemia major and related factors of patients referring to Thalassaemia Society in 1998. [Dissertation]. Tehran: Tehran University of Medical Sciences; 1998. [Article]
38. Shiva S, SariSorkhabi R. Short stature in patients with beta-thalassemia. Urmia Medical Journal. 2008; 19 (2): 125-131. [Article]
39. Hashemi A, Ordooei M, Golestan M, Akhavan Ghalibaf M, Mahmoudabadi F, Arefinia M, et al. Hypothyroidism and Serum Ferritin Level in Patients with Major ß Thalassemia. Iran J Ped Hematol Oncol 2011; 2(1): 53-56. [Article]
40. Arjmandi Rafsanjani K, Razzaghy-Azar M, Zahedi-Shoolami L, Vossough P, Modarres A, Taheri N. Bone Mineral Density in β Thalassemia Major and Intermedia, Correlation with Biochemical and Hormonal Profiles. IJBC. 2009; 1 (4):121-127. [Article]
41. Moayeri H, Oloomi Z. Prevalence of growth and puberty failure with respect to growth hormone and gonadotropins secretion in beta-thalassemia major. Arch Iran Med. 2006; 9(4): 329-34. [Article]
42. Eshraghi P, Mehrabani Tabari S, Mohseni A. An Avaluation of the Correlation between Short Stature and Endocrinopathy In Thalassemia Major Patients. J Mashad Univ Med Sci 2012; 55 (1): 7-14. [Article]
43. Saffari f, Abolfazl M. Bone mineral density in patients with Beta-Thalassemia Major in Qazvin. Journal of Isfahan Medical School. 2008; 26(89): 179-186. [Article]
44. Amanat Yazdi M, Hashemi A, Afkhami G, PourShamsi F. Evaluation relationship between endocrine disorders in B-thalassemic patients with serum ferritin levels. [Dissertation]. Yazd: Shahid Sadoughi University of Medical Sciences; 2004. [Article]
45. Karamifar H, Shahriari M, Sadjadian N. Prevalence of endocrine complications in beta-thalassaemia major in the Islamic Republic of Iran. Eastern Mediterranean health journal 2003; 9(1-2): 55-60. [Article]
46. Miri-Aliabad G, Fadaee M, Khajeh A, Naderi M. Marital Status and Fertility in Adult Iranian Patients with beta-Thalassemia Major. Indian journal of hematology & blood transfusion: an official journal of Indian Society of Hematology and Blood Transfusion 2016; 32(1): 110-3. [Article]
47. Hamidieh AA, Moradbeag B, Pasha F, Jalili M, Hadjibabaie M, Keshavarznia M. High Prevalence of Hypoparathyroidism in Patients with beta-Thalassemia Major. Int J Hematol Oncol Stem Cell Res 3(3); 2009: 17-20. [Article]
48. Company F, Rezaei R, Yosefi GH. Evaluation of hearing loss and otolaryngeal disorders in beta thalassemic patients treated with desferrioxamine. Sci J Kurdistan Univ Med Sci 2009; 14(3): 47-55. [Article]
49. Azimipour A, Asadi M. The prevalence of endocrine diseases in patients with thalassemia major. [Dissertation]. Qazvin: Qazvin University of Medical Sciences; 2001. [Article]
50. Spector TD, Thompson SG. The potential and limitations of meta-analysis. J Epidemiol Community Health 1991; 45: 89-92. [Article]
51. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-9. [Article]
52. Vandenbroucke JP, Elm Ev, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. PLoS Medicine 2007; 4(10): 1628. [Article]
53. Ades AE, Lu G, Higgins JP. The Interpretation of Random-Effects Meta-Analysis in Decision Models. Med Decis Making 2005; 25(6): 646-54. [Article]
54. Michael Borenstein, Larry V. Hedges, Julian P.T. Higgins, Hannah R. Rothstein. A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods 2010; 1(2): 97-111. [Article]
55. Azami M, Sharifi Sh, Sayehmiri K. Prevalence of Diabetes, Impaired Fasting Glucose and Impaired Glucose Tolerance in Patients with Thalassemia Major in Iran-A Meta-Analysis. Caspian Journal of Internal Medicine; 2016; In Press. [Article]
56. Sayemiri K, Tarde Z, Azami M, Milad Borji. The prevalence of hypogonadism in patients with thalassemia major in Iran – a systematic review and meta-analysis study. J Shahrekord Univ Med Sci 2016; In Press. [Article]
57. Azami M, Tardeh Z, Abangah G, Sayemiri K. The Prevalence of Impaired Glucose Tolerance in Patients with Thalassemia Major in Iran: A systematic Review and Meta-analysis. JSSU. 2016; 23(10):912-922. [Article]
58. Abolghasemi H, Eshghi P. Apprehensive thalassemia book. 2004. 1th ed. Tehran: Bagheiatallah Medical University, 2004. [Article]
59. Gamberini MR, De Sanctis V, Gilli G. Hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism: incidence and prevalence related to iron overload and chelation therapy in patients with thalassaemia major followed from 1980 to 2007 in the Ferrara Centre. Pediatric endocrinology reviews: PER 2008; 6(1): 158-69. [Article]
60. Toumba M, Sergis A, Kanaris C, Skordis N. Endocrine complications in patients with Thalassaemia Major. Pediatric endocrinology reviews: PER 2007; 5(2): 642-8. [Article]
61. Belhoul KM, Bakir ML, Kadhim AM, Dewedar HE, Eldin MS, Alkhaja FA. Prevalence of iron overload complications among patients with b-thalassemia major treated at Dubai Thalassemia Centre. Ann Saudi Med 2013; 33(1): 18-21. [Article]
62. Kurtoglu AU, Kurtoglu E, Temizkan AK. Effect of iron overload on endocrinopathies in patients with beta-thalassaemia major and intermedia. Endokrynol Pol 2012; 63(4): 260-3. [Article]
63. Kidson-Gerber GL, Francis S, Lindeman R. Management and clinical outcomes of transfusion-dependent thalassaemia major in an Australian tertiary referral clinic. The Medical journal of Australia 2008; 21; 188(2): 72-5. [Article]
64. Zervas A, Katopodi A, Protonotariou A, Livadas S, Karagiorga M, Politis C, et al. Assessment of thyroid function in two hundred patients with beta-thalassemia major. Thyroid: official journal of the American Thyroid Association 2002; 12(2): 151-4. [Article]
65. Habeb AM, Al-Hawsawi ZM, Morsy MM, Al-Harbi AM, Osilan AS, Al-Magamsi MS, et al. Endocrinopathies in beta-thalassemia major. Prevalence, risk factors, and age at diagnosis in Northwest Saudi Arabia. Saudi medical journal 2013; 34(1): 67-73. [Article]
66. Aleem A, Al-Momen AK, Al-Harakati MS, Hassan A, Al-Fawaz I. Hypocalcemia due to hypoparathyroidism in beta-thalassemia major patients. Annals of Saudi medicine 2000; 20(5-6): 364-6. [Article]
67. Mula-Abed WA, Al Hashmi H, Al Muslahi M, Al Muslahi H, Al Lamki M. Prevalence of endocrinopathies in patients with Beta-thalassaemia major - a cross-sectional study in oman. Oman medical journal 2008; 23(4): 257-62. [Article]
68. Multicentre study on prevalence of endocrine complications in thalassaemia major. Italian Working Group on Endocrine Complications in Non-endocrine Diseases. Clinical endocrinology 1995; 42(6): 581-6. [Article]
69. L. Even, T. Bader and Z. Hochbeg. Diurnal Variation of Serum Calcium, Phosporus and PTH in the Diagnosis of Hypoparathyroidism. Pediatric Research (Abstract), 2001; 3:141. [Article]
70. Chern JP, Lin KH, Lu MY, Lin DT, Lin KS, Chen JD, et al. Abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients. Diabetes care 2001; 24(5): 850-4. [Article]
71. Pouraboli B, Mansooreh Forouzi A, Arab M. Mental Health of Adolescents with Thalassemia Major Visiting Kerman Specific Diseases Center. Journal of Health & Development 2015; 4(1): 320-28. [Article]

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