[Hyperthyroidism after Allogeneic Hematopoietic Stem Cell Transplantation].

Xiao-Li Zheng, Hong-Min Yan, Li Xiao, Dong-Mei Han, Li Ding, Mei Xue, Ling Zhu, Jing Liu, Da Zhang, Heng-Xiang Wan
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Abstract

Objective: To investigate the clinical characteristics, etiology, therapy and outcome of hyperthyroidism after allogeneic hematopoietic stem cell transplantation (HSCT).

Methods: The clinical data of 7 patients who experienced hyperthyroidism were retrospectively analyzed in our hospital.

Results: These 7 patients (5 males, 2 females) suffered hyperthyroidism after HSCT. All patients did not apply the pretreatment regimen containing total body irradiation (TBI). The median age was 25 years old, only one child. Six patients underwent haploidentical HSCT except one patient after unrelated HSCT. The median time of hyperthyroidism occurrence was 20 months. Two patients experienced chronic graft versus host disease (GVHD) when hyperthyroidism occurred and were treated successfully with glucocorticoid, however one patient suffered hypothyroidism 3 months later and needed long-term oral levothyroxine maintenance. One patient developed hypothyroidism post treatment of 131I. The other four patients were treated with methimazole and all of them showed normal thyroid function except one patient suffered from hypothyroidism 1 year later and needed long-term oral levothyroxine maintenance.

Conclusion: Hyperthyroidism is a rare complication after HSCT but may affect healthy and lead to lower quality of life. Routine thyroid function monitoring should be recommended after HSCT. Treatment of hyperthyroidism should be given according to the pathogeny.

[异基因造血干细胞移植后甲状腺功能亢进]。
目的:探讨异基因造血干细胞移植(HSCT)后甲状腺功能亢进的临床特点、病因、治疗及转归。方法:回顾性分析我院收治的7例甲亢患者的临床资料。结果:7例患者(男5例,女2例)在HSCT后出现甲状腺功能亢进。所有患者均未采用含全身照射(TBI)的预处理方案。平均年龄25岁,只有一个孩子。6例患者接受了单倍体移植,1例患者接受了非相关的HSCT。甲亢发生的中位时间为20个月。2例患者发生甲状腺功能亢进时发生慢性移植物抗宿主病(GVHD),糖皮质激素治疗成功,但1例患者3个月后发生甲状腺功能减退,需要长期口服左旋甲状腺素维持。1例患者治疗后出现甲状腺功能减退。其余4例患者均给予甲巯咪唑治疗,除1年后出现甲状腺功能减退,需长期口服左旋甲状腺素维持外,其余患者甲状腺功能均正常。结论:甲状腺功能亢进是HSCT术后少见的并发症,但可能影响患者的健康,降低患者的生活质量。HSCT后应推荐常规甲状腺功能监测。甲状腺机能亢进的治疗应根据病因而定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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