Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Eur J Endocrinol. 2023 Jun 7;188(6):503-509. doi: 10.1093/ejendo/lvad058.
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.
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.
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.
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.
甲状腺功能障碍（甲状腺功能减退和甲状腺功能亢进）已被报道为儿童造血干细胞移植（HSCT）后的晚期效应。然而，HSCT 对甲状腺功能参数的短期影响尚不清楚。
我们前瞻性地评估了荷兰马克西玛公主中心在 2 年内接受 HSCT 的所有<21 岁的儿童在 HSCT 前和 3 个月时的甲状腺功能参数。
在 72 名儿童中，无 3 个月后出现甲状腺功能减退或甲状腺功能亢进。16%的儿童在 HSCT 前和 10%的儿童在 HSCT 后出现甲状腺功能参数改变（异常的促甲状腺激素[TSH]或游离甲状腺素[FT4]浓度）。9.3%的儿童在 HSCT 前和 37%的儿童在 HSCT 后出现三碘甲状腺原氨酸（rT3）升高，这可能与身体状况不佳有关。在 HSCT 后 3 个月，有 10.5%（6/57）的儿童 FT4 浓度下降≥20%。
总之，HSCT 后 3 个月甲状腺功能减退和甲状腺功能亢进非常罕见。这些结果表明，可能需要更晚的时间开始监测甲状腺功能减退和甲状腺功能亢进。HSCT 后 3 个月发现的甲状腺功能参数变化可能反映了甲状腺功能正常的病态综合征。
