Funkcija štitnjače u bolesnika s kroničnom reakcijom transplantanta protiv primatelja nakon alogenične transplantacije krvotvornih matičnih stanica

master's thesis

• Title (english): Thyroid function in patients with chronic graft versus host disease after allogeneic hematopoietic stem cell transplantation
• Author: Mislav Omerbašić
• Mentor: Tina Dušek (mentor)
• Committee member: Nadira Duraković (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Uvod: Bolesti štitnjače smatraju se kasnom komplikacijom alogenične transplantacije
krvotvornih matičnih stanica. Abnormalna funkcija štitnjače u navedenoj populaciji
bolesnika javlja se s učestalošću od 2-56%, ovisno o primarnoj bolesti, vrsti liječenja
uslijed i nakon transplantacije te starosti u vrijeme transplantacije. U ovom radu
istražujemo postoji li povezanost između bolesti štitnjače i kronične reakcije
transplantanta protiv primatelja. -----
Bolesnici i metode: U periodu od lipnja 2013. do ožujka 2018. u studiju je uključeno
118 bolesnika kod kojih je učinjena transplantacija koštane srži. Ovisno o tome jesu li
razvili cGvHD, podijeljeni su u dvije grupe: cGvHDpat (n=71) i non-cGvHDpat (n=47).
----- Rezultati: Do poremećaja funkcije štitnjače došlo je u u 30% bolesnika u grupi s
cGvHD, odnosno u 19% bolesnika u grupi kod bez cGvHD-a. Najčešće nađena vrsta
poremećaja funkcije štitnjače u obje skupine bila je subklinička hipotireoza (67% i
44%).
----- Zaključak: Bolesti štitnjače kasna su komplikacija post alo-TKMS. Nije pokazana
signifikantna značajnost da je cGvHD rizični čimbenik za povećanu incidenciju bolesti
štitnjače. Također, nije pokazana signifikantna razlika u kumulativnoj incidenciji
bolesti štitnjače u grupi cGvHDpat, odnosno non-cGvHDpat. Kod bolesnika koji su uz
cGvHD imali i poremećaj funkcije štitnjače pojavile su se u većoj mjeri i bolesti pluća,
gastrointestinalnog trakta, jetre, kože, usta i, u najvećem omjeru, bolesti očiju.

Abstract (english)

Introduction: Thyroid diseases are regarded as long-term complications after
allogeneic hematopoietic stem cell transplantation. Abnormal thyroid function in this
population occurs in 2-56% of patients, depending on primary disease, type of
treatment due to and after transplantation and the age at time of transplantation. The
aim of this study was to identify whether there is an association between thyroid
dysfunction and cGvHD, and to describe the characteristics of the affected patients.
----- Patients and methods: In period from June 2013 till March 2018 118 patients who
survived the transplantation were included in this study. Depending on whether they
developed cGvHD or not, they were divided into two groups: cGvHDpat (n=71) and
non-cGvHDpat (n=47).
----- Results: Abnormal thyroid function occurred in 30% of patients and 19% of controls.
The most frequent noticed thyroidopathy in patients and controls was subclinical
hypothyreosis, 67% and 44%, respectively.
----- Conclusion: Thyroid dysfunction is a long-term complication after allogeneic
hematopoietic stem cell transplantation. We did not prove that chronic graft versus
host disease is a significant risk factor for the increased incidence of thyroid diseases
in patients after transplantation. There was no significant difference in cumulative
incidence of thyroid disease in groups of cGvHDpat and non-cGvHDpat. Dysfunction
of lungs, gastrointestinal tract, liver, skin, mouth, and in the biggest ratio, diseases of
eyes were more prevalent in patients who developed cGvHD and had abnormal
thyroid function.

• Keywords: bolesti štitnjače; alogenična transplantacija krvotvornih matičnih stanica; kronična reakcija transplantanta protiv primatelja; subklinička hipotireoza
• Keywords (english): thyroid diseases; allogeneic hematopoietic stem cell transplantation; chronic graft versus host disease; subclinical hypothyreosis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:040665
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-17 10:09:13