Mohn A, Di Marzio A, Cerruto M, Angrilli F, Fioritoni C, Chiarelli F
Clinica Pediatrica, Universitá di Chieti, Chieti, Italy.
Pediatr Hematol Oncol. 2001 Apr-May;18(3):211-5. doi: 10.1080/08880010151114886.
Euthyroid sick syndrome is related to profound changes in thyroid metabolism induced by nonthyroidal diseases. To determine whether children with newly diagnosed Hodgkin disease might present thyroid abnormalities and to establish their predictive value, the authors performed regular thyroid function testing. Seven children (5 M, 2 F) with a mean age of 10.4 years (range: 4.6-15 years) at diagnosis were studied for a period of 6.9 years (4.2-10.5 years). Five patients presented at diagnosis with euthyroid sick syndrome characterized by borderline low thyroxine circulating levels (T3 0.8-1.3 ng/mL, FT3 1.5-1.7 pg/mL) and mildly raised TSH (4.6-5 microU/mL). Thyroid function turned normal within 6 months of therapy. Subsequently, 3 children developed overt hypothyroidism (T4 35-40 ng/mL, FT4 2-7 pg/mL, TSH 5.5-11 microU/mL) requiring substitution therapy. Euthyroid sick syndrome was not associated with a poorer outcome in terms of survival or long-term thyroid consequences. Thyroid function testing should be performed routinely at diagnosis and thereafter in children with Hodgkin disease to detect subtle abnormalities.
甲状腺功能正常的病态综合征与非甲状腺疾病引起的甲状腺代谢深刻变化有关。为了确定新诊断的霍奇金病患儿是否可能出现甲状腺异常并确定其预测价值，作者进行了定期的甲状腺功能测试。对7名诊断时平均年龄为10.4岁（范围：4.6 - 15岁）的儿童进行了6.9年（4.2 - 10.5年）的研究。5例患者在诊断时表现为甲状腺功能正常的病态综合征，其特征为循环甲状腺素水平临界低（T3 0.8 - 1.3 ng/mL，FT3 1.5 - 1.7 pg/mL）和TSH轻度升高（4.6 - 5 μU/mL）。甲状腺功能在治疗后6个月内恢复正常。随后，3名儿童出现明显的甲状腺功能减退（T4 35 - 40 ng/mL，FT4 2 - 7 pg/mL，TSH 5.5 - 11 μU/mL），需要替代治疗。就生存或长期甲状腺后果而言，甲状腺功能正常的病态综合征与较差的预后无关。对于霍奇金病患儿，应在诊断时及之后定期进行甲状腺功能测试，以检测细微异常。
