Endokrynologia Pediatryczna. Pediatric Endocrinology. ABSTRACT/ STRESZCZENIE. Introduction. Overweight and obesity are a growing health problem. Endokrynologia pediatryczna [Brown Rosalind S. Brook Charles G.D.] on *FREE* shipping on qualifying offers. Ksiazka jest poswiecona. Endokrynologia Pediatryczna. English title: Pediatric Endocrinology; ISSN: , ; GICID: ; DOI: /EP; Website.
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Growth hormone therapy wikipedialookup. Signs endokrynilogia symptoms of Graves’ disease wikipedialookup. Thank you for your participation! Growth hormone therapy wikipedialookup Signs and symptoms of Graves’ disease wikipedialookup. Long-term follow-up of hormonal function and growth in patients who received hematopoietic stem cell transplantation The prevalence of gonadal dysfunction did not depend on conditioning regimen. There was no pediatdyczna of gonadal recovery in any of the patients during the follow-up period.
In our study gonadal dysfunction in girls was a prominent complication of this procedure. As the number of endokrynloogia survivors is increasing, and patients recover from their primary disease, it is important to evaluate the impact of treatment-related toxicity on other organs.
Cancer therapy and pre-HSCT preparative regimens consist of cytotoxic drugs as well as irradiation, particularly affecting the endocrine function.
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The aim of this paper is to present the results of the above study and the impacts of HSCT procedures on the hormonal functions, as well as the growth and development of these patients. Patient characteristics are shown in Table I. Anthropometrics and pubertal status assessment Height Ht and weight Wt measurements were assessed at diagnosis, at HSCT and during each follow-up visit using a Harpenden stadiometer and a electronic scales.
The body mass index BMI was calculated with the following formula: Moreover, the height velocity HV was calculated using the following formula: The pubertal status was assessed clinically according to Tanner and Whitehouse. Patients characteristics Tabela I. peidatryczna
Prepubertal Pubertal 28 29 Primary Disease: SAA Others 23 6 7 12 6 3 Type of transplant: If needed, additional hormonal function tests as well as e. All tests were performed using commercially available assays.
Afterwards the results were compared with each other using Student t-test for independent variables. All statistical analysis was performed using Medcalc statistical software.
Results Growth and body mass The group as a whole showed a fall-off in growth after diagnosis with a little evidence of catch-up growth in the following HSCT years. In two boys the short stature was present before initial diagnosis, one of them was diagnosed with X-linked adrenoleukodystrophy X-ALD. The patients endorkynologia significantly higher after fourth year post 11 Praca oryginalna Endokrynol. Mean HVSD did not change.
Journal of Immunology Research
The data are presented in table II. GHD was a temporary finding in one patient, and the symptoms withdrew without treatment. Detailed data on anthropometric measurements are presented in table III. Secondary amenorrhea and symptoms typical for a menopause were identified in eight girls.
In males, testicular volumes were within normal ranges for age and pubertal status. Nine girls and three boys had shown elevated gonadotropin levels FSH and LH with lowered estradiol or testosterone respectively.
In all cases, a hormone replacement therapy was required. There was no evidence of gonadal recovery in any of the patients. Two patients underwent orchidectomy, due to primary disease relapse, and before the testosterone replacement therapy. The prevalence of gonadal dysfunction did not depend on conditioning regimen, as shown in table IV. All endoktynologia in that group had clinical symptoms of hypergonadotropic hypogonadism ovarian or testis failure.
One girl presented with hyperthyroidism with thyroid inflammation with present anti thyroid antibodies Table II. Overall anthropometric measurements referring to different criteria Tabela III.
Gonadal pediahryczna referring to conditioning protocol Tabela IV. She was administered antithyroid drugs, glucocorticoids and propranolol. At the last follow-up visit she still required antithyroid drugs. A second patient, also a female, presented with secondary hypothyroidism, and was endokrynoogia levothyroxine. She was conditioned with following protocols: In one patient it was connected to endokrgnologia primary disease X-ALD.
In seven patients, an adrenal dysfunction was observed probably due to graft versus host disease treatment with a high dose of glucocorticoids. Two cases involved endoorynologia glucose tolerance with OGTT.
An insulin treatment was indicated for the patient who had been diagnosed with diabetes. A diet with limited simple carbohydrates was initiated in all other cases, with a good outcome. Several studies documented endocrinal HSCT late side-effects in children adolescents and adults. Growth retardation has been a consistent finding in patients who undergo HSCT treatment. The etiology of this problem is considered as a combination of multiple factors: There are several studies that prove conditioning regimens, such as irradiation, both cranial or TBI, result in greatest height impairment in children.
A greater growth impairment was observed in patients who had received a single dose TBI than those treated with fractionated TBI [11, 12].
Endokrynologia Pediatryczna Pediatric Endocrinology
On the other hand, some therapeutic regimens, such as Busulfan-Cyclophosphamide BUCY conditioning regimen for acute myeloid leukemia AMLare believed to have no effect on growth [13, 14].
In our study a similar effect of this treatment was observed . Again, this problem can be attributed to both chemo- and radiotherapy [15, 20]. As pediatric patients are not at the age to consider pregnancy, the indirect signs of gonadal dysfunction have to endokrrynologia inquired, such as elevated gonadotropins.
In males elevated serum FSH levels reflect germinal epithelium damage and impaired spermatogenesis. The higher FSH levels, the more reduced testicular endokrynologoa are observed. Elevated LH levels reflect Leydig cell insufficiency. Testosterone level is usually in low normal.
Gynaecomastia is less pediqtryczna [13, 21]. Young women are at higher risk of premature menopause. The risk of a permanent gonadal failure depends on the treatment regimen: According to some studies the prepubertal status of patients at the time of transplantation cannot be considered as a protective factor against endokynologia treatment-induced gonadal damage [20, 23]. Other investigators suggest the opposite [24, 25].
Therefore long-term monitoring of gonadal function in children who were treated with HSCT at prepubertal age is an important issue. Some researchers suggest that male subjects tended to recover more quickly after BMT than females . Moreover, most of the girls had a complete gonadal failure and most of the boys had spontaneous puberty but a germinal epithelial failure.
The most frequent type of thyroid dysfunction in long term survivors is hypothyroidism, both overt and clinically compensated. Hyperthyroidism is a rare condition . Recent studies demonstrated that the thyroid gland was especially sensitive to irradiation at very young age . In our study, two female patients presented with thyroid dysfunction: Hypothyroidism occurred one year after her second HSCT. A second girl, who underwent HSCT at the age of 6,5yrs, presented with thyrotoxicosis 30 months post-transplantation.
Tatevossian reported a similar case in . Neither of these patient had TBI. Similar cases were observed in our study group. Conclusions In children endokrynologiq adolescents who undergo hematopoietic stem cell transplantation, growth impairment and the endocrine system disorders have been observed to occur frequently post transplantation.
We have demonstrated that gonadal dysfunction is a prominent adverse effect of the HSCT procedure, especially in girls.
Endocrine consequences of treatment of malignant disease. Late complications after allogeneic bone marrow transplantation for leukemia. Endocrinological late complications after hematopoietic SCT in children. Physical growth of Swiss children from birth to 20 years of age.
Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Late effects after stem cell transplantation SCT pediiatryczna children–growth and hormones. Growth and development following marrow transplantation for leukemia.
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Growth and endocrine function following bone marrow transplantation for thalassemia major. Patterns of gonadal dysfunction following bone marrow transplantation. Ovarian function after autologous bone marrow transplantation in childhood: Ovarian function after bone marrow transplantation during childhood.
Longitudinal gonadal function after bone marrow transplantation for acute lymphoblastic leukemia during childhood.