HYPOTHYROIDISM AND GRAVES-DISEASE AFTER MANTLE IRRADIATION - A FOLLOW-UP-STUDY

被引:18
作者
MORTIMER, RH
HILL, GE
GALLIGAN, JP
BRANSDEN, AI
TYACK, SA
ROESER, HP
机构
[1] UNIV QUEENSLAND, DEPT MED, ST LUCIA, QLD 4067, AUSTRALIA
[2] N BRISBANE HOSP BOARD, HAEMATOL, BRISBANE, QLD, AUSTRALIA
[3] N BRISBANE HOSP BOARD, DIV CHEM PATHOL, BRISBANE, QLD, AUSTRALIA
[4] N BRISBANE HOSP BOARD, CONJOINT INTERNAL MED LAB, BRISBANE, QLD, AUSTRALIA
来源
AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE | 1986年 / 16卷 / 03期
关键词
D O I
10.1111/j.1445-5994.1986.tb01184.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Fifty of 66 patients whose thyroid function had previously been assessed 7-139 months after irradiation for Hodgkin''s disease were re-evaluated 35 .+-. 3 months later. They could be divided into three groups: those whose thyroid function had been normal in the first study (N = 26), those who had asymptomatic impaired thyroid reserve (N = 19), and those in whom evidence of Graves'' disease had developed (N = 5). The 26 patients who had been euthyroid when first studied had developed significant increases in mean thyroid-stimulating hormone (TSH) levels (basal and following thyrotrophin releasing hormone) without changes in mean free thyroxine index (FTI). In three of these patients, each studied within six years of irradiation, basal TSH had risen to hypothyroid levels. There were no significant changes in mean FTI or basal and peak TSH in 19 patients who had demonstrated impaired thyroid reserve in the first study. The cumulative incidence of impaired thyroid reserve in the total cohort is now 30/66 (45%) but only one of these 30 has developed clinical hypothyroidism. Five patients developed evidence of Graves'' disease. Two patients with thyrotoxicosis and one with euthyroid Graves'' disease were found in the initial study. On re-evaluation, a third patient had developed frank thyrotoxicosis and another euthyroid Graves'' disease, giving a cumulative incidence of Graves'' disease of 5/66 (7%). Three of these five were HLA-DR3 and three had measurable thyrotrophin binding inhibiting immunoglobulins. We conclude that impaired thyroid reserve continues to develop within six years of mantle irradiaton in adults but once established appears to remain stable. There also appears to be a high incidence of Graves'' disease after mantle irradiation.
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页码:347 / 351
页数:5
相关论文
共 36 条
  • [1] CARMEL RJ, 1976, CANCER-AM CANCER SOC, V37, P2813, DOI 10.1002/1097-0142(197606)37:6<2813::AID-CNCR2820370637>3.0.CO
  • [2] 2-S
  • [3] ABNORMALITIES IN THYROID-FUNCTION IN RELATIVES OF PATIENTS WITH GRAVES-DISEASE AND HASHIMOTOS THYROIDITIS - LACK OF CORRELATION WITH INHERITANCE OF HLA-B8
    CHOPRA, IJ
    SOLOMON, DH
    CHOPRA, U
    YOSHIHARA, E
    TERASAKI, PI
    SMITH, F
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1977, 45 (01) : 45 - 54
  • [4] UNRESPONSIVENESS TO THYROTROPIN-RELEASING-HORMONE (TRH) IN TREATED GRAVES HYPERTHYROIDISM AND IN EUTHYROID GRAVES-DISEASE
    CLIFTONBLIGH, P
    SILVERSTEIN, GE
    BURKE, G
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1974, 38 (04) : 531 - 538
  • [5] CONSTINE LS, 1984, CANCER-AM CANCER SOC, V53, P878, DOI 10.1002/1097-0142(19840215)53:4<878::AID-CNCR2820530411>3.0.CO
  • [6] 2-J
  • [7] DAVIES TF, 1983, AUTOIMMUNE ENDOCRINE, P127
  • [8] SERIAL THYROID-FUNCTION MEASUREMENTS IN CHILDREN WITH HODGKIN DISEASE
    DEVNEY, RB
    SKLAR, CA
    NESBIT, ME
    KIM, TH
    WILLIAMSON, JF
    ROBISON, LL
    RAMSAY, NKC
    [J]. JOURNAL OF PEDIATRICS, 1984, 105 (02) : 223 - 227
  • [9] DONAICH I, 1953, BRIT J CANCER, V7, P181
  • [10] DETECTING UNSUSPECTED THYROID-DYSFUNCTION BY THE FREE-THYROXINE INDEX
    DOSREMEDIOS, LV
    WEBER, PM
    FELDMAN, R
    SCHURR, DA
    TSOI, TG
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1980, 140 (08) : 1045 - 1049