Changes in thyroid function parameters 3 months after allogeneic and autologous hematopoietic stem cell transplantation in children

European Journal of Endocrinology, vol. 188, pp. 503–509

Abstract

BACKGROUND: Thyroid dysfunction (hypo- and hyperthyroidism) has been reported as a late effect after hematopoietic stem cell transplantation (HSCT) in children. Short-term effects of HSCT on thyroid function parameters are, however, unclear. METHODS: We prospectively evaluated thyroid function parameters before and 3 months after HSCT in all children (<21 years) who underwent HSCT during a 2-year period in the Princess Máxima Center, the Netherlands. RESULTS: Among 72 children, none had thyroidal hypothyroidism or hyperthyroidism 3 months after HSCT. Changes in thyroid function parameters (either aberrant thyroid-stimulating hormone [TSH] or free thyroxine [FT4] concentrations) were found in 16% before and in 10% 3 months after HSCT. Reverse triiodothyronine (rT3) was found elevated in 9.3% before and in 37% 3 months after HSCT, which could be related to poor physical condition. An individual decline in FT4 concentration of ≥20% was found in 10.5% (6/57) 3 months after HSCT. CONCLUSION: In conclusion, thyroidal hypo- and hyperthyroidism are very rare 3 months after HSCT. These results indicate that surveillance for hypo- and hyperthyroidism may start later in time. The changes in thyroid function parameters found 3 months after HSCT might reflect euthyroid sick syndrome.

Authors 10

1. Chantal Anne Lebbink

   University Medical Center Utrecht · Princess Máxima Center · Wilhelmina Children's Hospital

   Affiliation as printed

   Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands

   Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

2. Dorine Bresters

   Princess Máxima Center

   Affiliation as printed

   Stem Cell Transplantation Unit, Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

3. Joni P B Tersteeg

   University Medical Center Utrecht · Wilhelmina Children's Hospital

   Affiliation as printed

   Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands

4. Cor van den Bos

   Princess Máxima Center

   Affiliation as printed

   Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

5. Miranda P. Dierselhuis

   Princess Máxima Center

   Affiliation as printed

   Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

6. Eef G.W.M. Lentjes

   University Medical Center Utrecht

   Affiliation as printed

   Laboratory Clinical Chemistry and Hematology, University Medical Center Utrecht , Utrecht , The Netherlands

7. A. A. Verrijn Stuart

   University Medical Center Utrecht · Wilhelmina Children's Hospital

   Affiliation as printed

   Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands

8. Marta F. Fiocco Aachen Department of Biomedical Science Section Medical Statistics

   Leiden University · Leiden University Medical Center · Princess Máxima Center

   Affiliation as printed

   Mathematical Institute Leiden University, The Netherlands and Department of Biomedical Science, Section Medical Statistics, Leiden University Medical Centre , Leiden , The Netherlands

   Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

   Mathematical Institute Leiden University, The Netherlands and Department of Biomedical Science, Section Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands

9. Wim J. E. Tissing

   University Medical Center Groningen · University of Groningen · Princess Máxima Center

   Affiliation as printed

   Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands

   Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

   Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

10. Hanneke Margo van Santen corresponding

    University Medical Center Utrecht · Princess Máxima Center · Wilhelmina Children's Hospital

    Affiliation as printed

    Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands

    Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands