Primary adrenal insufficiency in a child after busulfan and cyclophosphamide-based conditioning for hematopoietic stem cell transplantation
-
Senay Savas-Erdeve
, Merih Berberoglu
, Zeynep Siklar , Bulent Hacihamdioglu , Gonul Ocal , Mehmet Ertem , Talia Ileri , Elif Unal Ince and Zumrut Uysal
Abstract
High rates of skeletal complications, growth disturbances, thyroid and gonadal dysfunction have been described in children undergoing stem cell transplantation. Although secondary adrenal insufficiency has been diagnosed, no primary adrenal insufficiency has been reported after busulfan and cyclophosphamide (Bu/Cy)-based conditioning regimens for stem cell transplantation in children. A 9-year-old girl with myelodysplastic syndrome was treated with stem cell transplantation of allogeneic origin. She received myeloablative conditioning chemotherapy, Bu and Cy. Her serum cortisol level was normal before stem cell transplantation. Then, 17 months after stem cell transplantation, chronic graft-versus-host disease developed and was treated with methyl prednisolone for 3 months. The control endocrinological investigation revealed low serum cortisol and high serum adrenocorticotropin (ACTH) levels 6 months after completion of methyl prednisolone treatment. The ACTH stimulation test demonstrated primary adrenal insufficiency, and the other etiologies of primary adrenal insufficiency were excluded. The patient received oral prednisolone replacement therapy. She was followed-up for 44 months and required increases in steroid doses during stress periods. Primary adrenal insufficiency which was observed in our patient after Bu/Cy-based conditioning regimen for stem cell transplantation has not been reported in children and adrenal function should be closely monitored in these patients both before stem cell transplantation and after stem cell transplantation.
©2011 by Walter de Gruyter Berlin Boston
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- Insulin-like growth factor-1 (IGF-1) serum concentration among 7-year-old extremely low birth weight children – an indicator of growth problems
- The effect of the length of the prodromal period on the metabolic control within the first 2 years in children with diabetic ketoacidosis manifestation
- Clinical characteristics at presentation of type 1 diabetes mellitus in children younger than 15 years in Croatia
- Umbilical cord oxidative stress in infants of diabetic mothers and its relation to maternal hyperglycemia
- The relationship between serum magnesium levels wıth childhood obesity and insulin resistance: a review of the literature
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- A novel AVPR2 missense mutation in a Chinese boy with severe inherited nephrogenic diabetes insipidus
- From idiopathic diabetes insipidus to neurodegenerative Langerhans cell histiocytosis – an unusual presentation and progression of disease
- Unique concurrent appearance of two rare conditions in a young girl: central precocious puberty due to hypothalamic hamartoma and uncommon type of diabetes
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- Unexpected finding of an intact distal vagina in an infant with mixed gonadal dysgenesis
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