Acute Deficiency of Thyroxine-Binding Globulin during L-Asparaginase Therapy

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Abstract
ESCHERICHIA COLI L-asparaginase, an antileukemic agent, acts by hydrolyzing plasma L-asparagine to L-aspartic acid and ammonia, resulting in depletion of plasma L-asparagine levels.1 , 2 Cells susceptible to the cytotoxic effects lack asparagine synthetase and thus require exogenous asparagine for growth.3 Administration of L-asparaginase has been associated with modest decreases in the plasma concentrations of albumin, cholesterol, insulin, fibrinogen and various clotting factors.2 , 4 We report on a transient but dramatic reduction in serum thyroxine-binding globulin with consequent changes in results of thyroid-function studies in patients receiving L-asparaginase.MethodsThyroid function was monitored in patients with acute lymphocytic leukemia receiving Esch. coli L-asparaginase. . . .

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