The Incidence and Risk Factors of the Euthyroid Sick Syndrome Soon after Allogeneic Hematopoietic Stem Cell Transplantation in Children.

Abstract Purpose: In this study, we analyzed the short term change of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation(HSCT) in children. Method: We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH(thyroid stimulating hormone), total serum thyroxine, total serum triiodothyronine levels were systematically measured in 80 patients before and 1 month, 6 month and 12 month after HSCT. Results: Thyroid function was statistically decreased at 1 month after HSCT(P < 0.001). Thyroid dysfunction at 1 month was observed in 43(54%) of 80 patients, 31(39%) of whom presented with euthyroid sick syndrome. Thyroid dysfunction was normalized within 1 year after HSCT(Table). In univariate analysis, malignant disease and presence of acute GvHD(grade ≥II) were risk factors for euthyroid sick syndrome(P = 0.04, 0.01). In multivariate analysis, we could not detect an independent risk factor for euthyroid sick syndrome(P = 0.19, 0.06). Conclusion: The present study suggests that the incidence of thyroid dysfunction is high after allogeneic HSCT. Therefore, regular monitoring of thyroid hormone levels after HSCT is required. Short-term changes in thyroid function after HSCT Pre HSCT Post HSCT 1 month Post HSCT 6 month Post HSCT 12 month T3 (ng/dL) 161 ± 27 100 ± 35 123 ± 35 124 ± 35 T4 (μg/dL) 8.7 ± 1.6 6.5 ± 2.4 7.3 ± 1.8 7.7 ± 1.6 TSH (mIU/L) 2.9 ± 1.9 1.2 ± 1.3 2.4 ± 1.8 2.1 ± 1.3