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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thyroid function and scans were evaluated in fifty disease-free patients 2 to 16 years after receiving neck irradiation for the treatment of Hodgkin's disease. Twenty-five of 50 patients had abnormal thyroid studies: eight were hypothyroid, two were hypothyroid and had abnormal scans, and fifteen had abnormal scans. Of the 15 patients with abnormal scans, one had an isolated elevation of TSH (thyroid stimulating hormone) and one developed exophthalmos. These data, obtained within a relatively short follow-up period, indicate that morphologic and functional abnormalities of the thyroid gland are not uncommon in patients who have received irradiation to the thyroid gland in the course of treatment for Hodgkin's disease. There is need for continuous reevaluation of the thyroid status in such patients.
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PMID:Thyroid abnormalities following neck irradiation for Hodgkin's disease. 72 60

The authors report a case of hypothyroid hypertrophic myopathy consecutive to mantle irradiation for Hodgkin's disease. A rise in TSH level is frequent after mantle irradiation and it justifies prolonged monitoring of these patients' thyroid function, in view of the risk of patent hypothyroidism and perhaps cancer. The patient's age, the pre-irradiation lymphography and the chemotherapy associated with radiotherapy are all factors that influence the incidence of thyroid dysfunction, but there is no agreement concerning their relative importance. Hypertrophic myopathies due to hypothyroidism are rare, and their dramatic clinical presentation contrasts with an almost normal muscle histology. Alterations of energy metabolism and changes in the properties of myosin induced by hormonal deficiency account for the muscular weakness of these patients. On the other hand, the mechanism of muscle hypertrophy remains controverted, the most probable theory being and increase in the number of myotubes. Following irradiation, notably for Hodgkin's disease, the frequency of hypothyroidism requires a regular and systematic laboratory follow-up. Replacement therapy must be instituted if the basal TSH level increases, even if the T4 level is normal.
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PMID:[Hypothyroid hypertrophic myopathy following mantle irradiation for Hodgkin's disease. A case]. 189 13

Thirty five patients with Hodgkin's disease who had received mantle radiotherapy to the neck were investigated for thyroid dysfunction serially over many years post radiation. No incidence of clinical hypothyroidism was noted; however, biochemical hypothyroidism (raised TSH, normal T3 and T4) was seen at some time during follow up in 22 patients. Thirteen had high TSH values at the first post radiation examination: in 6 they remained high during follow up and in seven they fell to normal or near normal without thyroxine substitution at any time. TSH abnormalities were seen by 2-3 years post radiotherapy and the return to normal, when it occurred, was seen by 4-6 years. It is advisable to follow up patients with abnormal TSH values following mantle radiation for a further 2-3 years and begin thyroxine substitution only if TSH abnormalities persist.
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PMID:Follow up of alterations in thyroid hormones and thyrotropin in patients of Hodgkin's disease given mantle radiation. 226 75

Fifty-four clinically euthyroid patients were evaluated 1 up to 17 yr after external irradiation to the neck for Hodgkin's disease. T4 level was decreased in 6%, while basal TSH level was increased in 44%, and TSH response to TRH was increased in 66% of the patients with normal basal TSH level. Thyroid iodine content (TIC), measured in 50 patients, was below 5 mg in 18. The 29 patients with normal basal TSH level had a mean TIC (6.8 +/- 2.7 mg) significantly lower (p less than 0.01) than the control population (14.6 +/- 5 mg). A significant positive correlation was found between log T4 and log TIC (r = 0.55, p less than 0.01). Thyroglobulin (Tg) level was increased in 53% of the patients with no palpable thyroid abnormality. It was not related to TSH level but was related to younger age at irradiation. T4 treatment decreased Tg level to the normal range in 5 of 8 patients. These facts suggest subclinical thyroid abnormalities and patients with elevated Tg levels should be considered at risk for developing a thyroid tumor.
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PMID:Thyroid iodine content and serum thyroglobulin level following external irradiation to the neck for Hodgkin's disease. 236 55

Radiotherapy to the neck and/or polychemotherapy late effects on the thyroid were investigated in 51 patients (34 males and 17 females) with Hodgkin's disease. Except for two untreated, recently diagnosed patients, all were studied after 1 to 105 months (median, 27.5 months) of completion of polychemotherapy. Age ranged from 6.2 to 36.6 years (median, 13.6 years). Patients were divided according to treatment into four groups: (A) patients treated with CVPP (cyclophosphamide, vinblastine, procarbazine, and prednisone); (B) 22 patients treated with CVPP plus radiotherapy (median radiation dose to the thyroid, 3000 cGy); (C) seven patients with ACOP/BVP (adriamycin, cyclophosphamide, vincristine, prednisone, bleomycin, vinblastine, procarbazine); and (D) seven patients treated with different polychemotherapy protocols, four of whom also received radiotherapy. Elevated basal and/or post-TRH, -TSH levels were found in the following: Group A: two of 12 patients (17%); Group B: 11 of 22 (50%); Group C: four of seven (57%); and Group D: two of seven (28%). Positive antimicrosomal thyroid antibody titers (AM Ab) were found in the following: Group A: three of 12 patients (25%); Group B: six of 21 (28%), Group C: two of seven (28%); and Group D: one of six (17%). Of 46 patients studied, 12 (26%) had positive AM Ab; 37 of 46 patients were younger than 20 years of age, 11 (30%) of whom had positive AM Ab versus 4% in the normal population (P less than 0.001). Two recently diagnosed, untreated patients had either high TSH response to TRH or positive AM Ab. In conclusion, higher frequency of thyroid dysfunction was observed in patients receiving radiotherapy (50% versus 27%). Prevalence of positive AM Ab, apparently unrelated to therapy, was higher in young patients than in the normal population. A predisposition to autoimmune thyroid disease seems to be present in these patients, but it is not possible to discern how lymphoma and thyroiditis are interrelated.
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PMID:Thyroid dysfunction in Hodgkin's disease. 246 71

Since pediatric Hodgkin's disease is a curable malignancy, it is essential to limit treatment sequelae. This study examines post-treatment pulmonary, cardiac, and thyroid function in 34 children, ages 5 to 17 (23 male and 11 female) with Hodgkin's disease. All received combined modality therapy of 6 cycles of alternating ABVD/MOPP chemotherapy and low dose (1500-2500 cGy) involved field radiotherapy. Mean follow-up period is 27.5 months with actuarial freedom from relapse of 94% and survival of 92%. Twenty asymptomatic patients underwent pulmonary function testing following chemotherapy and supradiaphragmatic radiotherapy. Eleven patients had post-treatment carbon monoxide diffusing capacity (DLCO) performed. Six of 11 children (55%) had abnormal values (mean 66%, range 58-80) showing either a reduced DLCO compared to pretreatment or an low absolute value. Eight of the twenty patients (40%) tested post-treatment for FEV1, FVC, TLC and flow volume loop had abnormal results. Six showed restrictive abnormalities and two had obstructive dysfunction. Fourteen patients underwent cardiac nuclear gated angiogram after completion of chemotherapy. Two asymptomatic patients (14%) had abnormal scans showing either a low resting ejection fraction or a decreased response to exercise. Thyroid function was evaluated post-treatment in twenty-one patients by TSH, T4, free T4 or sensitive TSH analysis. Four (21%) had an elevated TSH with a normal T4 after treatment. Although post-treatment thyroid and cardiac effects were minimal, post-treatment pulmonary dysfunction in asymptomatic patients was substantial with more than 50% of tested children demonstrating an abnormal DLCO and 40% showing restrictive or obstructive pulmonary parameters. These abnormalities were observed following a maximum bleomycin dose of 60 units/m2. Bleomycin and pulmonary radiotherapy have adverse effects on diffusing capacity and the long-term pulmonary sequlae of combined ABVD chemotherapy and radiotherapy are unknown. Our analysis suggests that even in asymptomatic children, pulmonary abnormalities are frequent.
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PMID:Pediatric Hodgkin's disease: pulmonary, cardiac, and thyroid function following combined modality therapy. 246 27

Clinical charts and biopsies of 32 children with thyroid nodules were reviewed at the National Children's Hospital from 1970 to 1988. The classification between benign and malignant types was only possible by surgery and biopsy. Twenty three (72%) were found to be benign forms and nine (28%) were carcinomas (8 papillary and one follicular). Two of the carcinomas had been irradiated previously because of neuroblastoma, as well as one of the benign type who received radiation to the neck and mediastinum because of a Hodgkin's disease. No patients showed alteration in thyroid functional test (T4 and TSH). Twenty two per cent of the carcinomas and 16% of the benign forms presented higher retention in the gammagram test. Seventy eight per cent of the carcinomas and 70% of the benign types showed a normal gammagram test. Surgery in the benign cases included 10 hemithyroidectomy, 7 sub-total thyroidectomy, 3 total thyroidectomy and 3 node resection. Carcinoma cases included 6 patients with total thyroidectomy with ganglionar modified dissection in three patients; 2 hemithyroidectomy and one with sub-total thyroidectomy. Complications included 3 hypoparathyroidisms, one of them permanent, 3 transitory recurrent paresis and only one child died because of pulmonary metastasis. All carcinoma patients were treated with levothyroxine and three of them also received 1131 in order to control ganglionar metastasis. Total survival rate for carcinoma patients was 83% at 90 months. It is concluded that only with surgery it is possible to classify correctly the histological type of children with thyroid nodes. Clinical evaluation and laboratory tests are useless. However, it has not been defined how big the surgery must be.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Thyroid nodules in children. Experience at the National Children Hospital of Costa Rica]. 260 73

We studied the height growth of 96 children presenting with acute leukemia or non Hodgkin lymphoma, together with an investigation of GH and TSH in 41 of them. There were 2 groups: group I consisting of 19 patients without brain irradiation and group II consisting of 77 patients with prophylactic brain irradiation. Initial average height was identical in both groups. Growth rate was significantly decreased in group II but not in group I (p less than 0.01). There is a correlation between the decrease of growth rate and the decrease of GH to arginine stimulation test (p less than 0.03). A lack of response to GRF-44 was noted in 4 of 11 investigated patients. TSH and prolactin secretions were unchanged.
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PMID:[Growth of children treated for leukemia or malignant lymphoma. Influence of cranial radiotherapy]. 289 28

While impairment of thyroid function has been demonstrated for high-dose external radiation (e.g., for Hodgkin's disease), the long-term functional effects of low-dose external radiation have not been fully explored. One hundred fifty-three subjects with a past history of thymic irradiation during infancy were stratified into three dose levels and compared with 51 nonirradiated subjects from a sibling cohort with respect to previously undiagnosed clinical and laboratory thyroidal abnormalities. There was no apparent association between previous thymic irradiation and mean serum levels of T4, free T4, TSH, or antithyroid antibodies, nor was the prevalence of undetected hypothyroidism or hyperthyroidism significantly altered in the irradiated group. Serum thyroglobulin levels were elevated in subjects with palpable thyroid nodules, all of which occurred in thymic-irradiated subjects. Thus persons who have received low-level external thymic irradiation in infancy should continue to have periodic thyroid examinations, but routine serial measurement of other serum thyroidal parameters does not appear to be indicated.
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PMID:A comparative study between individuals receiving thymic irradiation in infancy and their nontreated siblings: clinical and laboratory thyroid abnormalities. 358 50

In an attempt to reduce the incidence of hypothyroidism following irradiation of the neck, we administered oral L-thyroxine in doses sufficient to suppress serum TSH to 20 patients receiving radiation therapy for Hodgkin's disease or other lymphomas. L-thyroxine was discontinued when radiation therapy was completed. Twenty similar patients who did not receive L-thyroxine during radiation therapy served as a control group. After a mean follow-up period of 33 months, seven patients (35%) in the L-thyroxine group developed elevation of serum TSH and were started on chronic L-thyroxine therapy. In the control group, after mean follow-up of 19 months, five patients (25%) developed elevation of TSH and were started on chronic L-thyroxine. We conclude that suppression of serum TSH during neck irradiation does not prevent subsequent thyroid dysfunction.
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PMID:Thyroxine administration during radiation therapy to the neck does not prevent subsequent thyroid dysfunction. 393 71


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