TY - JOUR
T1 - Thyroid Profile in the First Three Months after Starting Treatment in Children with Newly Diagnosed Cancer
AU - Lebbink, Chantal A.
AU - van den Bos, Cor
AU - Dierselhuis, Miranda P.
AU - Fiocco, Marta
AU - Verrijn Stuart, Annemarie A.
AU - Lentjes, Eef G. W. M.
AU - Plasschaert, Sabine L. A.
AU - Tissing, Wim J. E.
AU - van Santen, Hanneke M.
N1 - Funding Information: This research was supported by Stichting Kinderen Kankervrij (KiKa) (project 340). Publisher Copyright: © 2023 by the authors.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: Thyroid hormone anomalies during childhood might affect neurological development, school performance and quality of life, as well as daily energy, growth, body mass index and bone development. Thyroid dysfunction (hypo- or hyperthyroidism) may occur during childhood cancer treatment, although its prevalence is unknown. The thyroid profile may also change as a form of adaptation during illness, which is called euthyroid sick syndrome (ESS). In children with central hypothyroidism, a decline in FT4 of >20% has been shown to be clinically relevant. We aimed to quantify the percentage, severity and risk factors of a changing thyroid profile in the first three months of childhood cancer treatment. Methods: In 284 children with newly diagnosed cancer, a prospective evaluation of the thyroid profile was performed at diagnosis and three months after starting treatment. Results: Subclinical hypothyroidism was found in 8.2% and 2.9% of children and subclinical hyperthyroidism in 3.6% and in 0.7% of children at diagnosis and after three months, respectively. ESS was present in 1.5% of children after three months. In 28% of children, FT4 concentration decreased by ≥20%. Conclusions: Children with cancer are at low risk of developing hypo- or hyperthyroidism in the first three months after starting treatment but may develop a significant decline in FT4 concentrations. Future studies are needed to investigate the clinical consequences thereof.
AB - Background: Thyroid hormone anomalies during childhood might affect neurological development, school performance and quality of life, as well as daily energy, growth, body mass index and bone development. Thyroid dysfunction (hypo- or hyperthyroidism) may occur during childhood cancer treatment, although its prevalence is unknown. The thyroid profile may also change as a form of adaptation during illness, which is called euthyroid sick syndrome (ESS). In children with central hypothyroidism, a decline in FT4 of >20% has been shown to be clinically relevant. We aimed to quantify the percentage, severity and risk factors of a changing thyroid profile in the first three months of childhood cancer treatment. Methods: In 284 children with newly diagnosed cancer, a prospective evaluation of the thyroid profile was performed at diagnosis and three months after starting treatment. Results: Subclinical hypothyroidism was found in 8.2% and 2.9% of children and subclinical hyperthyroidism in 3.6% and in 0.7% of children at diagnosis and after three months, respectively. ESS was present in 1.5% of children after three months. In 28% of children, FT4 concentration decreased by ≥20%. Conclusions: Children with cancer are at low risk of developing hypo- or hyperthyroidism in the first three months after starting treatment but may develop a significant decline in FT4 concentrations. Future studies are needed to investigate the clinical consequences thereof.
KW - childhood cancer treatment
KW - pediatrics
KW - thyroid dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85149845309&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers15051500
DO - https://doi.org/10.3390/cancers15051500
M3 - Article
C2 - 36900289
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 5
M1 - 1500
ER -