title: Long-term follow-up of thyroid function in patients who received bone marrow transplantation during childhood and adolescence.
abstract: An increasing number of long-term surviving bone marrow transplant (BMT) recipients have recovered from their primary disease but are at risk of developing failure of endocrine organs. We investigated 147 patients who underwent allogeneic BMT. Thyroid function was evaluated by serial measurement of basal TSH and free T4 levels as well as by TRH provocative test. Thyroid ultrasound examination was performed for evaluation of thyroid tumor after BMT. Five patients were found to have overt thyroid dysfunction (hypothyroidism in four patients and hyperthyroidism in one patient). Twenty-three patients in the under 9-yr-old group at BMT and 16 patients in the over 10-yr-old group at BMT had subclinical compensated hypothyroidism. Younger age at BMT was the strongest factor for developing thyroid dysfunction, compared with older age (P < 0.001). Only in patients with subclinical compensated hypothyroidism did median basal and peak TSH increase to the upper half of the normal range by 8 yr after BMT and then returned slightly to the middle of the normal range spontaneously. These results suggest that thyroid dysfunction in long-term BMT survivors depends on age at BMT, with a greater risk among younger patients, indicating the need for life-long surveillance.
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan. h-ishi@is.icc.u-tokai.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishiguro
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Yuuichiro
authors.initials: Y
authors.lastname: Tomita
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shinagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Kinya
authors.initials: K
authors.lastname: Hattori
authors.forename: Masae
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Inoue
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yabe
authors.forename: Miharu
authors.initials: M
authors.lastname: Yabe
authors.forename: Osamu
authors.initials: O
authors.lastname: Shinohara
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kato
mesh_terms: D000236:Adenoma / Q000209:etiology; D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology; D007037:Hypothyroidism / Q000209:etiology; D015994:Incidence; D008297:Male; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013964:Thyroid Neoplasms / Q000209:etiology; D014463:Ultrasonography