Endocrine complications after busulphan and cyclophosphamide based hematopoietic stem cell transplant: A single tertiary care centre experience
| Autor: | Rajan Kapoor, Sandeep Kharb, Satyanarayan Das, MK Dutta, Rajeev Pakhetra, Abhay Gundgurthi, Sanjeevan Sharma, MK Garg, Velu Nair |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
growth hormone deficiency
medicine.medical_specialty Pediatrics Endocrinology Diabetes and Metabolism lcsh:Diseases of the endocrine glands. Clinical endocrinology Growth hormone deficiency Endocrinology Hypergonadotropic hypogonadism Diabetes mellitus Internal medicine medicine Adrenal insufficiency Endocrine system hypogonadism lcsh:RC799-869 hematopoietic stem cell transplant lcsh:RC648-665 diabetes business.industry medicine.disease Impaired fasting glucose Graft-versus-host disease surgical procedures operative lcsh:Diseases of the digestive system. Gastroenterology Original Article hypothyroidism business Hormone |
| Zdroj: | Indian Journal of Endocrinology and Metabolism Indian Journal of Endocrinology and Metabolism, Vol 17, Iss 5, Pp 855-863 (2013) |
| ISSN: | 2230-8210 |
| Popis: | Introduction: Endocrine complications are common after hematopoietic stem cell transplant (HSCT). Although HSCT is performed at various centers in India, no study is available for endocrine dysfunctions among them. This study was carried out with the objective to evaluate endocrine dysfunction among patients undergone HSCT in the past. Materials and Methods: We carried out a cross-sectional study in a 50 post-HSCT recipients (39 allogenic, 11 autologous). All relevant data were collected from patient′s records. Samples for hormonal estimation were collected and stimulation tests for cortisol and growth hormone were interpreted based on peak values achieved during insulin tolerance test. Results: The mean age of patients was 26.3 ± 16.9 years (range 4-74). Adrenal insufficiency (AI) was present in 60%, hypergonadotropic hypogonadism (HH) in 60%, growth hormone deficiency (GHD) in 54%, hypothyroidism in 4%, hyperprolactinemia in 4%, new onset diabetes after transplant in 4%, and impaired fasting glucose in 6%. Multiple endocrine complications were common. GHD was present in 77% of children (n = 22) although height standard deviation score was not statistically different compared to those who didn′t have GHD. HH was present in 36% of children. In adults (n = 28), 36% had GHD, all females had HH, and 89% of males had HH. Germ cell dysfunction with compensated Leydig cell dysfunction was the most common pattern of HH in males. Fifteen patients had graft versus host disease (GVHD). GVHD had no bearing on development of endocrine deficiencies. AI was related to duration after and type of transplant, but was unrelated to steroid intake. Conclusions: Endocrine manifestations are common after HSCT; they can occur as early or late complications. All HSCT recipients should have endocrine evaluation as per prevailing guidelines. |
| Databáze: | OpenAIRE |
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