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Early-onset thyrotoxicosis after unrelated cord blood transplantation for acute myelogenous leukemia.

Authors
  • Konuma, Takaaki
  • Tomonari, Akira
  • Takahashi, Satoshi
  • Ooi, Jun
  • Tsukada, Nobuhiro
  • Yamada, Toshiki
  • Sato, Hiroyuki
  • Nagayama, Hitomi
  • Iseki, Tohru
  • Tojo, Arinobu
  • Asano, Shigetaka
Type
Published Article
Journal
International journal of hematology
Publication Date
May 01, 2006
Volume
83
Issue
4
Pages
348–350
Identifiers
PMID: 16757437
Source
Medline
License
Unknown

Abstract

Thyroid dysfunction is a common complication after allogeneic hematopoietic stem cell transplantation (SCT). However, thyrotoxicosis as defined by elevated serum-free thyroxine (FT4) or free triiodothyronine (FT3) levels together with low thyroid-stimulating hormone (TSH) levels is rare after SCT. Here we describe 2 patients who developed thyrotoxicosis within the first 50 days after unrelated cord blood transplantation (CBT). Patient 1 is a 32-year-old woman with acute myelogenous leukemia (AML)-M5a who underwent CBT. On day +41, she developed tachycardia. On day +48, FT4 increased to 2.2 ng/dL and TSH was suppressed to less than 0.1 microU/mL. Antithyroid peroxidase antibody was positive. On day +83, FT4 spontaneously decreased to 1.4 ng/dL. Patient 2 is a 42-year-old man with AML-M4 who underwent CBT. On day +42, he developed tachycardia. On day +48, FT3 increased to 4.75 pg/mL and TSH was suppressed to 0.02 microU/mL. Antithyroid peroxidase antibody was positive. Eight months after CBT, his thyroid function spontaneously returned to normal. The presence of antithyroid peroxidase antibody suggested that immune-mediated reactions might be associated with the development of thyrotoxicosis after CBT in our patients. The present study shows that thyrotoxicosis can occur during very early periods after CBT.

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