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February 2010, Volume 60, Issue 2

Letter to the Editor

“Frequency of hypothyroidism in Patients with b-thalassemia”

Madam, reference to my article titled "Frequency of Hypothyroidism in patients of b-Thalassemia" published in the January 2010 issue of JPMA. Thankyou for the feedback.
As regards the comments:
Tests for serum ferritin levels in the our patient population were repeated every few months or so. The values we recorded were those measured within the last 6 months from the time of sample collection.
In this study, a significant association was found between ferritin levels and thyroid functional status; the ferritin levels of hypothyroid patients being significantly higher than those of euthyroid patients. Several studies have however reported a lack of concordance of ferritin concentrations with the thyroid function status. As mentioned under the section titled "Discussion", this may be, in part, due to the fact that serum ferritin levels increase linearly with the transfusion load up to 100 units of transfused blood, but thereafter there is no simple relationship. Also, misleading ferritin levels can occur with chronic inflammatory disease as well as vitamin C deficiency. Also the results may differ because of different treatment protocols followed in different areas.
All our patients were suboptimally chelated which is why no comparison groups could be formed to evaluate the effect of adequate chelation on thyroid status.
Sara Malik
Department of Pathology, Ziauddin Medical University, Karachi.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: