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    Endocrine deficit after fractionated total body irradiation.

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    Authors
    Ogilvy-Stuart, Amanda L
    Clark, D J
    Wallace, W Hamish B
    Gibson, B E
    Stevens, R F
    Shalet, Stephen M
    Donaldson, M D
    Affiliation
    Royal Hospital for Sick Children, Yorkhill, Glasgow.
    Issue Date
    1992-09
    
    Metadata
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    Abstract
    Endocrine function was assessed in 31 children (17 boys) after fractionated total body irradiation used in the preparative regimen for bone marrow transplantation. Endocrine dysfunction was present in 25 children. Fifteen of 29 had growth hormone insufficiency 0.9-4.9 years after total body irradiation, yet only three of the 15 had received previous cranial irradiation. Five of 30 had thyroid dysfunction: two with a low thyroxine and raised thyroid stimulating hormone (TSH) concentration and three with a raised TSH and normal thyroxine concentration. Thus the incidence of thyroid dysfunction (16%) is much lower than that reported after single fraction total body irradiation (39-59%). In only two children were abnormalities of the hypothalamic-pituitary-adrenal axis demonstrated. The majority of pubertal children assessed (n = 15) showed evidence of gonadal damage. All the pubertal girls (n = 5) had ovarian failure, although there was evidence of recovery of ovarian function in one girl. All seven boys in late puberty showed evidence of damage to the germinal epithelium, and two of three in early puberty had raised follicle stimulating hormone concentrations. Despite the use of a fractionated total body irradiation regimen, endocrine morbidity is substantial and children undergoing such procedures will require long term endocrine review and management.
    Citation
    Endocrine deficit after fractionated total body irradiation. 1992, 67 (9):1107-10 Arch Dis Child
    Journal
    Archives of Disease in Childhood
    URI
    http://hdl.handle.net/10541/109644
    DOI
    10.1136/adc.67.9.1107
    PubMed ID
    1417055
    Type
    Article
    Language
    en
    ISSN
    1468-2044
    ae974a485f413a2113503eed53cd6c53
    10.1136/adc.67.9.1107
    Scopus Count
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