Tsuyoshi Shinagawa

Changes in thyroid function after bone marrow transplant in young patients.

Abstract Background : Changes in thyroid function among young patients who received bone marrow transplantation (BMT) were evaluated.

Spontaneous reduction of a recurrent craniopharyngioma in an 8-year-old female patient: case report.

OBJECTIVE AND IMPORTANCE The spontaneous rupture of a craniopharyngioma is an extremely rare condition confined to adults. This is the first report of a patient younger than 10 years who experienced spontaneous reduction (possibly rupture) of a craniopharyngioma. CLINICAL PRESENTATION An 8-year-old female patient with a recurrence of a craniopharyngioma experienced fever, headache, and visual disturbance that lasted a few days. Concurrent with the improvement of these symptoms, marked reduction in the size of the tumor was revealed using magnetic resonance imaging, suggesting the occurrence of a rupture. INTERVENTION Subsequent magnetic resonance imaging of the hypothalamic-pituitary region was performed while the patient received growth hormone therapy. CONCLUSION There was no increase in the size of the tumor 1 year after the reduction occurred. Prompt evaluation of the hypothalamic-pituitary region using magnetic resonance imaging is warranted to rule out the possibility of spontaneous reduction (including rupture) of the tumor in a situation in which the patient with a craniopharyngioma shows meningeal signs or a rapid change of neurological symptoms (such as headache, fever, or visual disturbance).

Growth and Endocrine Function in Long-term Adult Survivors of Childhood Stem Cell Transplant

The number of long-term surviving stem cell transplant (SCT) recipients has increased steadily, and attention has now extended to the late complications of this procedure. The objective of this study was to investigate relationship among growth and endocrine functions in long-term adult survivors of childhood SCT. The inclusion criteria of this study were survival at least 5 yr after SCT and achievement of adult height. Fifty-four patients (39 males) fulfilled these criteria and were included in this study. Growth was mainly evaluated by height standard deviation score (SDS) and individual longitudinal growth curves. Among the 54 patients, those that received SCT before 10 yr of age showed significantly greater reductions in changes in height SDS (mean –1.75, range –4.80 to –0.10) compared with those that received SCT at or after 10 yr of age (mean –0.50, range –1.74 to 1.20; P<0.001). The mean loss of height for all patients who received SCT during childhood was estimated to be approximately 1 SDS/6.5 yr (r=0.517). Individual longitudinal growth curves indicated that a significant growth spurt was absent in severe short stature patients during the pubertal period without severe endocrine dysfunctions including GH deficiency. The incidence of growth disorder in long-term adult survivors depends on the age at SCT and whether they received radiation therapy. Life-long follow-up is necessary for survivors to detect, prevent and treat the late endocrine complications in SCT survivors.