guidebook. - Fanconi Anemia Research Fund

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Fanconi Anemia: Guidelines for Diagnosis and Management
performed. The impact of androgen therapy on height
and maturation should be discussed with the family.
During androgen therapy, the BA should be reassessed
every six months.
Multiple transfusion therapy
Multiple transfusion therapy can affect endocrine
function through the mechanism of iron overload (see
Chapter 3). Iron deposition in endocrine glands can
affect testicular function, contribute to development
of diabetes, and can lead to primary hypothyroidism,
hypoparathyroidism or pituitary dysfunction.
Hematological cell transplant
Transplantation is associated with a state of illness.
Illness is not an optimal time to assess any hormone
concentrations, as thyroid levels, growth, gonadal function,
nutrition, and glucose regulation are often altered
in illness (see Chapter 9 and 10). For example:
• Cytoxan has a known dose-related effect on
gonadal function in both males and females.
• Glucocorticoids can lead to elevation in appetite,
weight gain, insulin resistance, and hyperglycemia,
even to the extent of requiring insulin
therapy.
• Metaclopromide raises prolactin. This can lead
to galactorrhea or fluid from the breasts, and
alteration of thyroid function or pubertal development.
• Anticonvulsant therapy can lead to alteration of
thyroid function or thyroid dose requirement.
Some anticonvulsants, such as Valproate, can
lead to weight gain and altered ovarian function.