title: Changes in thyroid function after bone marrow transplant in young patients.
abstract: BACKGROUND
  Changes in thyroid function among young patients who received bone marrow transplantation (BMT) were evaluated.
  
  
  METHODS
  The study included 91 patients (50 males) who underwent BMT from 1985 to 1995 at the age of 0.6-21 years. Sixty patients had neoplastic disease such as leukemia or lymphoma, and the remainder had non-neoplastic diseases. Preconditioning regimen for BMT included 12 Gy of fractionated-total body irradiation (TBI) for patients with neoplastic disease and 3-8 Gy of irradiation for the remaining patients, in addition to chemotherapy. Evaluation of thyroid function was performed by serial assessment of basal serum FT4, FT3, TSH concentrations as well as by TRH test.
  
  
  RESULTS
  No patient had overt hypothyroidism or elevated basal TSH concentrations (>10 mU/L). However, 6 (7%) of patients experienced exaggerated peak TSH response to TRH stimulation several years after BMT. In 33 patients whose thyroid status was evaluated before, within 3 months, and 1 year after BMT, serum FT3 concentrations as well as peak TSH response to TRH stimulation significantly decreased immediately after BMT (<3 months) and normalized within 1 year. However, serum FT4 concentrations did not change significantly. One patient developed primary hypothyroidism and another developed follicular adenoma of the thyroid 5 and 12 years after BMT, respectively.
  
  
  CONCLUSIONS
  Short-term changes in thyroid function after BMT can indicate euthyroid sick syndrome rather than tertiary hypothyroidism. It must be noted that overt hypothyroidism may occur several years after BMT, hence long-term follow-up of thyroid function is warranted.
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishiguro
authors.forename: Yuichirou
authors.initials: Y
authors.lastname: Tomita
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Inoue
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shinagawa
authors.forename: Kinya
authors.initials: K
authors.lastname: Hattori
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yabe
authors.forename: Chidori
authors.initials: C
authors.lastname: Kubota
authors.forename: Miharu
authors.initials: M
authors.lastname: Yabe
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kato
authors.forename: Osamu
authors.initials: O
authors.lastname: Shinohara
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005067:Euthyroid Sick Syndromes / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis / Q000209:etiology; D007223:Infant; D008297:Male; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood; D013973:Thyrotropin-Releasing Hormone; D013997:Time Factors; D019172:Transplantation Conditioning
chemical_list: D013963:Thyroid Hormones; D013973:Thyrotropin-Releasing Hormone