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Thyroid function after bone marrow transplantation: possible association between immune-mediated thyrotoxicosis and
1Department of Hematology and Oncology, Faculty of Medicine, University of Tokyo, Japan.
Transplantation
|March 10, 2001
Summary
Early thyroid dysfunction after bone marrow transplantation (BMT) is common. Thyrotoxicosis frequently occurs within the first year and may predict later hypothyroidism, suggesting immune-mediated thyroid injury.
Area of Science:
- Endocrinology
- Hematology
- Transplantation Medicine
Background:
- Thyroid dysfunction is a recognized late complication of bone marrow transplantation (BMT).
- Limited data exists on early thyroid function changes post-BMT.
Purpose of the Study:
- To prospectively investigate early thyroid function changes after BMT.
- To identify patterns and predictors of thyroid dysfunction post-transplant.
Main Methods:
- Prospective study of 57 patients undergoing BMT.
- Monthly thyroid function tests (TSH, FT3, FT4) for the first 3 months post-BMT.
- Follow-up testing at 3-12 months and in the second year.
Main Results:
- Euthyroid sick syndrome (ETS) and thyrotoxicosis were common in the first 6 months.
- Thyrotoxicosis occurred in 7 patients, a novel finding, with median onset at 111 days.
- Hypothyroidism developed in 8 patients by 1 year, sometimes following transient thyrotoxicosis.
Conclusions:
- Thyrotoxicosis may be a distinct early complication of BMT.
- Thyrotoxicosis may predict the subsequent development of hypothyroidism.
- Immune-mediated thyroid injury likely contributes to post-BMT hypothyroidism.