title: Early-onset thyrotoxicosis after unrelated cord blood transplantation for acute myelogenous leukemia.
abstract: Thyroid dysfunction is a common complication after allogeneic hematopoietic stem cell transplantation (SCT). However, thyrotoxicosis as defined by elevated serum-free thyroxine (FT4) or free triiodothyronine (FT3) levels together with low thyroid-stimulating hormone (TSH) levels is rare after SCT. Here we describe 2 patients who developed thyrotoxicosis within the first 50 days after unrelated cord blood transplantation (CBT). Patient 1 is a 32-year-old woman with acute myelogenous leukemia (AML)-M5a who underwent CBT. On day +41, she developed tachycardia. On day +48, FT4 increased to 2.2 ng/dL and TSH was suppressed to less than 0.1 microU/mL. Antithyroid peroxidase antibody was positive. On day +83, FT4 spontaneously decreased to 1.4 ng/dL. Patient 2 is a 42-year-old man with AML-M4 who underwent CBT. On day +42, he developed tachycardia. On day +48, FT3 increased to 4.75 pg/mL and TSH was suppressed to 0.02 microU/mL. Antithyroid peroxidase antibody was positive. Eight months after CBT, his thyroid function spontaneously returned to normal. The presence of antithyroid peroxidase antibody suggested that immune-mediated reactions might be associated with the development of thyrotoxicosis after CBT in our patients. The present study shows that thyrotoxicosis can occur during very early periods after CBT.
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sato
authors.forename: Hitomi
authors.initials: H
authors.lastname: Nagayama
authors.forename: Tohru
authors.initials: T
authors.lastname: Iseki
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D001327:Autoimmune Diseases / Q000097:blood* / Q000209:etiology / Q000276:immunology; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000150:complications / Q000276:immunology / Q000628:therapy; D008297:Male; D012075:Remission, Spontaneous; D013971:Thyrotoxicosis / Q000097:blood* / Q000209:etiology / Q000276:immunology; D013974:Thyroxine / Q000097:blood / Q000276:immunology; D014184:Transplantation, Homologous; D014284:Triiodothyronine / Q000097:blood / Q000276:immunology
chemical_list: D001323:Autoantibodies; D014284:Triiodothyronine; D007453:Iodide Peroxidase; D013974:Thyroxine