EP1487 - ECE_2528 - Etiological diagnosis of hypothyroidism after craniofacial radiotherapy

Le résumé fourni par la source

Abstract Introduction Radiotherapy for craniofacial cancers often leads to various forms of thyroid dysfunction as a significant late complication. The aim of this study is to identify the different causes of hypothyroidism following external radiotherapy. Materials and Methods This was a cross-sectional study involving 22 patients treated with external radiotherapy who developed hypothyroidism during post-radiation follow-up. Results 22 patients—10 men and 12 women—who experienced hypothyroidism following craniofacial radiation therapy were included in the study. Of these, 21 had nasopharyngeal carcinoma and one had Hodgkin's lymphoma. Over an average of 12 months, a dose of 72 ± 2 Gray was administered. The average interval between the end of radiation therapy and the hypothyroidism diagnosis was four years. Six cases had central hypothyroidism, with an inappropriate TSH (4.5 ± 2 mIU/L) and an average FT4 level of 4.1 pg/mL. Peripheral hypothyroidism was present in 14 cases. Anti-thyroperoxidase antibody levels were ten times higher than normal in four patients. Low FT4 levels (4.6 pg/mL), inappropriate TSH levels (12 mIU/L and 0.32 mIU/L), and elevated anti-thyroperoxidase antibody titers (82 and 890 IU/mL) were found in two cases with a mixed origin. Conclusions Hypothyroidism is the most common thyroid disorder after radiotherapy. It may be peripheral, due to direct toxicity or autoimmune damage, or central, isolated or occurring as part of hypothalamic-pituitary injury, or mixed. Therefore, regular thyroid function monitoring is essential for the early detection of post-radiation hypothyroidism.

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