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Arch Iran Med. 2018;21(2): 56-60.
PMID: 29664655
  Abstract View: 675
  PDF Download: 495

Original Article

Short-term Assessment of HSCT Effects on the HypothalamusPituitary Axis in Pediatric Thalassemic Patients

Amir Ali Hamidieh 1, Fariba Mohseni 2, Maryam Behfar 3, Zohreh Hamidi 2, Kamran Alimoghaddam 3, Mohamad Pajouhi 2, Bagher Larijani 2, Mohammad-Reza Mohajeri-Tehrani 2 * , Ardeshir Ghavamzadeh 3

1 Pediatric Stem Cell Transplant Department Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
2 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Hematology-Oncology and Stem Cell Transplantation Research Center of Tehran University of Medical Sciences, Tehran, Iran
Corresponding Author: Mohammad-Reza Mohajeri-Tehrani, MD; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 5th Floor, Shariati Hospital, North kargar Ave., Tehran 14114, Iran. Fax: +9821-88220052, Tel: +9821-88220037-38 mrmohajeri@tums.ac.ir

Abstract

Background: Beta thalassemia major (BTM) and its treatment by hematopoietic stem cell transplantation (HSCT) may have deleterious effects on the endocrine systems. We assessed endocrine complications of HSCT in pediatric patients for 3 months.

Methods: In 20 (6 female) pediatric major thalassemic patients (mean age of 10.8 ± 3.9 years old), prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), T4, T3, thyroid-stimulating hormone (TSH), IGF-1, testosterone (in males) or estradiol (in females) were measured as a batch at the Endocrinology and Metabolism Research Center (EMRC) of Tehran University of Medical Sciences (TUMS) laboratories before HSCT and 1 and 3 months afterwards. The cosyntropin test for all and the clonidine test for short stature patients was conducted before HSCT.

Results: Before HSCT, delayed puberty and hypogonadotropic hypogonadism was found in 10% and 20% of patients, respectively. GH deficiency, low IGF1 and short stature was found in 25%, 55% and 40% of patients, respectively. Hypocortisolism, hypothyroidism and panhypopituitarism was found in 15%, 10% and 15% of patients, respectively. Prevalence of hypogonadotropic hypogonadism, low IGF1, hypothyroidism and panhypopituitarism was found in 20%, 40%, 10% and 10% of patients after 3 months, respectively (delayed puberty and short stature prevalence do not change after 3 months). HSCT caused lower T3 and estradiol and higher TSH. Corticosteroid users (15) had higher GH and lower T3 and testosterone or estradiol. Ferritin had a significant (negative) correlation with (before) prolactin and a significant correlation with T3 and T4 after HSCT. Age and acute graft-versus-host disease (GVHD) had no significant effect.

Conclusion: Considering the small sample size and short duration of the study, it is difficult to reach any conclusion however it seems HSCT does not appear to have an overall positive or negative effect on prevalence of pituitary- hypothalamus axis disorders in pediatric thalassemic patients in 3 months. 

Keywords: Endocrine disorders, HSCT, Hypothalamus, Pituitary, Thalassaemia
Cite this article as: Hamidieh AA, Mohseni F, Behfar M, Hamidi Z, Alimoghaddam K, Pajouhi M, et al. Short-Term assessment of HSCT effects on the hypothalamus-pituitary axis in pediatric thalassemic patients . Arch Iran Med. 2018;21(2):56–60.
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Submitted: 02 Aug 2016
Accepted: 28 Jan 2018
ePublished: 01 Feb 2018
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