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Acute thyrotoxicosis after SCT

Bone Marrow Transplantation volume 43, pages 663–664 (2009)Cite this article

Hypothyroidism and the presence of thyroid autoantibodies after SCT have been described earlier and are highly prevalent.1 (Autoimmune) thyroid failure may be triggered by conditioning chemotherapy, TBI and graft-versus-host effect.2 However, data on thyrotoxicosis or thyroid hormone excess are scarce and limited to case reports and case series.3, 4, 5, 6, 7

Between February 2006 and August 2007, 3 of 85 patients (3.5%) receiving SCT in our unit developed clinical thyrotoxicosis. Patient characteristics and transplant modalities are shown in Table 1. The respective numbers of patients receiving an allo-SCT without TBI, an allo-SCT with TBI, an autologous SCT without TBI and an autologous SCT with TBI within this time period were 20, 16, 47 and 2. Of the 36 patients receiving allo-SCT, 17 were treated with alemtuzumab (Campath-1H) and 19 without alemtuzumab. A significantly higher incidence of thyrotoxicosis occurred in patients also receiving TBI as compared with patients not treated with TBI (3/18 patients (17%) compared with 0/65 patients (0%), respectively (P<0.01, Fisher's exact test). There was no significant difference in the incidence of thyrotoxicosis between patients treated with alemtuzumab (Campath-1H) or not, either between auto- or allo-SCT.

Table 1 Patient characteristics
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Authors and Affiliations

  1. Department of Internal Medicine, Division of Endocrinology, AZ St. Jan AV, Brugge, Belgium

    S De Waele & A Van den Bruel

  2. Department of Internal Medicine, Division of Hematology, AZ St. Jan AV, Brugge, Belgium

    D Selleslag

  3. Department of Pathology, AZ St. Jan AV, Brugge, Belgium

    I Van Den Berghe

  4. Department of Endocrinology, UZ Gasthuisberg, Leuven, Belgium

    B Decallonne

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  1. S De Waele
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  2. A Van den Bruel
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  4. I Van Den Berghe
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Correspondence to A Van den Bruel.

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De Waele, S., Van den Bruel, A., Selleslag, D. et al. Acute thyrotoxicosis after SCT. Bone Marrow Transplant 43, 663–664 (2009). https://doi.org/10.1038/bmt.2008.374

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