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Thyroid dysfunctions in adult patients after allogeneic hematopoietic stem cell transplantation
Author(s) -
Ataca Atilla Pinar,
Akkus Erman,
Atilla Erden,
Gokmen Neslihan,
Civriz Bozdag Sinem,
Kurt Yuksel Meltem,
Toprak Selami Kocak,
Baskal Nilgun,
Akan Hamdi,
Demirer Taner,
Topcuoglu Pervin,
Arslan Onder,
Ilhan Osman,
Ozcan Muhit,
Beksac Meral,
Gurman Gunhan
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14049
Subject(s) - medicine , euthyroid , subclinical infection , hematopoietic stem cell transplantation , thyroid function , thyroid , transplantation , thyroid function tests , cumulative incidence , thyroid disease , euthyroid sick syndrome , complication , pediatrics , surgery , gastroenterology
Thyroid dysfunction (TD) is one of the major endocrinopathies shown after allogeneic hematopoietic stem cell transplantation over the long term. The incidence and the risk factors for TD have varied widely. Patients and Methods Two hundred and fifty‐nine patients with pre‐transplant normal thyroid function tests who survived at least 1 year after allo‐HSCT between 2006‐2016 were included in the study. Results Sixty‐four patients (25%) developed TD at median of 34 months (range, 1‐112 months). Hypothyroidism was detected in 32 patients (12%): 5 patients had primary hypothyroidism, and subclinical hypothyroidism occurred in 27 patients. 18 patients (7%) were diagnosed with hyperthyroidism: 2 patients (0.07%) were treated for primary hyperthyroidism, and 16 patients (6%) were followed for subclinical hyperthyroidism. Euthyroid sick syndrome occurred in 14 cases. None of the patients with thyroid dysfunction developed secondary thyroid malignancy. Receiving high‐dose TBI ( P = .001) was found to be significant risk for hypothyroidism; older age than median ( P = .01) and pre‐transplant active disease ( P < .0001) were related to hyperthyroidism. Conclusions Thyroid dysfunction, mostly hypothyroidism, is a long‐term complication after allo‐HSCT in 25% of patients. Older age, pre‐transplant active disease, and receiving TBI are among the risk factors. Sustained long‐term monitoring of thyroid function test should be considered post allo‐HSCT.