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R. WINDECK and M. WANKMÜLLER

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R. WINDECK, A. WACKER and D. REINWEIN

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H. PFINGSTEN, R. HAASE, R. WINDECK, W. REINHARDT, C. JASPERS, I. LANCRANJAN, G. BENKER and D. REINWEIN

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G. BENKER, H. RASCHE, TH. OLBRICHT, J. TEUBER, R. WINDECK, H. SCHULTE and D. REINWEIN

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TH. OLBRICHT, S. RIEDERER, G. BENKER, R. WINDECK, H. G. HOFF and D. REINWEIN

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G. Benker, Th. Olbricht, R. Windeck, R. Wagner, H. Albers, S. Lederbogen, H. G. Hoff and D. Reinwein

Abstract. Fifty-three patients with subacute thyroiditis (SAT) were seen during the acute stage of the disease. HLA-Bw 35 was positive in 33 out of 39 tested patients. At first presentation, all examined patients (N = 23) had ultrasound abnormalities (generalized hypodensity, single or multiple hypodense areas). Serum T4 and/or T3 were increased in 24/52, free T4 in 11/23, and the TSH response to TRH was flat in 8/11 patients. Six of 12 in whom volumetry was performed had goitres. Thirty-seven patients were re-examined after a mean follow-up interval of 46.5 months. At this follow-up, serum T4, free T4 and T3 levels as well as the sonographically determined thyroid volume had decreased, but there was still abnormalities by ultrasound detected in 14/36 patients; 19.4% had focal sonolucent lesions, whereas the prevalence of such lesions was only 3.1% in asymptomatic controls. Three patients were subclinically hypothyroid at the follow-up, whereas all others were euthyroid. Patients with abnormal ultrasound findings were of the same age and had a similar thyroid size, but a slightly higher TSH and a significantly (P<0.02) lower free T4 than those with normal ultrasound findings. They also had a higher prevalence of thyroid autoantibodies in low titres. Serum thyroglobulin was elevated in more than half of the patients during the acute phase, but only in 1 out of 11 patients during follow-up. Thyroglobulin at the follow-up was not related to TSH, but there was a correlation with thyroid volume (r = 0.57). In conclusion, thyroid abnormalities regarding both function and ultrasound findings are sufficiently frequent after SAT to warrant close observation of the patient. Conversely, abnormal ultrasound findings and diminished thyroid function, when not explained by other factors, should suggest the possibility of past SAT.

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G. Benker, U. Schäfer, U. Hermanns, M. K. Mahmoud, Th. Olbricht, H. M. Schulte, R. Windeck and D. Reinwein

Abstract. Twenty-three patients (13 females, 10 males) with panmyelopathy (N = 9), chronic leukemia (N = 5), and acute leukemias (N = 9) were studied 1 to 6 years following allogenic bone marrow transplantation. All patients had received conditioning treatment with cyclophosphamide prior to aBMT, and 2 of the patients with bone marrow aplasia and all of the leukemia patients had been given radiotherapy. An endocrine assessment was performed by means of TRH, GnRH, oCRF and GHRH tests and estimation of thyroid and gonadal hormones. Whereas pituitary-adrenal function appeared to remain stable, there was a 17.4% incidence of subclinical hypothyroidism (25% of the irradiated patients). Growth hormone reserve was diminished, and ovarian failure occurred in all female patients after radiotherapy, whereas in the men, only a moderate elevation of gonadotropins was observed. Our results warrant observation of thyroid and gonadal function, and in children of growth hormone secretion, after allogenic bone marrow transplantation. They also show that replacement therapy may be needed in some patients.