Euthyroid sick syndrome : an important clinical problem
Despite absence of thyroid disease, patients with non-thyroidal illness frequently have changes in serum thyroid hormone measurements that may suggest thyroid dysfunction. These abnormalities include low serum triiodothyronine, high reverse triiodothyronine and usually normal or inappropriately low thyrotropin and thyroxine levels. The degree of thyroid function impairment correlates with disease severity and low levels of thyroid hormones, particularly thyroxine, predict a poor prognosis. Considerable controversy exists on whether the fall in thyroid hormone levels is adaptive and simply a normal, physiologic response to conserve energy, or whether it is maladaptive and requires treatment. Interpretation of thyroid function tests in the critically ill patient can be difficult and differential diagnosis of euthyroid sick syndrome is challenging, particularly in patients in whom no test results from before the onset of a critical illness are available. In recent years, some questions associated with euthyroid sick syndrome have been better understood. The purpose of this article is to review the present state of knowledge on the pathogenesis, diagnosis and clinical consequences of euthyroid sick syndrome to discuss pros and cons of its treatment.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:70 |
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| Enthalten in: |
Wiadomosci lekarskie (Warsaw, Poland : 1960) - 70(2017), 2 pt 2 vom: 30., Seite 376-385 |
| Sprache: |
Polnisch |
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| Beteiligte Personen: |
Krysiak, Robert [VerfasserIn] |
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| Anmerkungen: |
Date Completed 02.05.2019 Date Revised 02.05.2019 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM277280362 |
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| 520 | |a Despite absence of thyroid disease, patients with non-thyroidal illness frequently have changes in serum thyroid hormone measurements that may suggest thyroid dysfunction. These abnormalities include low serum triiodothyronine, high reverse triiodothyronine and usually normal or inappropriately low thyrotropin and thyroxine levels. The degree of thyroid function impairment correlates with disease severity and low levels of thyroid hormones, particularly thyroxine, predict a poor prognosis. Considerable controversy exists on whether the fall in thyroid hormone levels is adaptive and simply a normal, physiologic response to conserve energy, or whether it is maladaptive and requires treatment. Interpretation of thyroid function tests in the critically ill patient can be difficult and differential diagnosis of euthyroid sick syndrome is challenging, particularly in patients in whom no test results from before the onset of a critical illness are available. In recent years, some questions associated with euthyroid sick syndrome have been better understood. The purpose of this article is to review the present state of knowledge on the pathogenesis, diagnosis and clinical consequences of euthyroid sick syndrome to discuss pros and cons of its treatment | ||
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