NONTHYROIDAL ILLNESS SYNDROME OR EUTHYROID SICK SYNDROME?

1996 ◽  
Vol 2 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Inder J. Chopra, MD, FACP
Keyword(s):  
Nonthyroidal Illness ◽  
Euthyroid Sick Syndrome

Nonthyroidal illness

2011 ◽  
pp. 336-344
Author(s):  
R.P. Peeters
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Disease ◽  
Clinical Signs ◽  
Negative Energy ◽  
Nonthyroidal Illness ◽  
Hormone Levels ◽  
Euthyroid Sick Syndrome ◽  
Thyroid Hormone Levels ◽  
Low Levels ◽  
Save Energy

A few hours after the onset of acute illness, marked changes in serum thyroid hormone levels occur. This is referred to as nonthyroidal illness (NTI). The most characteristic and persistent abnormality is a low level of serum triiodothyronine (T3). Despite these low levels of serum T3, patients usually have no clinical signs of thyroid disease. Other terms for this disease state have been used, e.g. the low T3 syndrome and the euthyroid sick syndrome. In addition to nonthyroidal illness, a low T3 in euthyroid patients is seen during caloric deprivation and after the use of certain types of medication (see Chapter 3.1.4). Low levels of thyroid hormone in hypothyroidism are associated with a decreased metabolic rate. Both in nonthyroidal illness and in fasting there is a negative energy balance in the majority of cases. Therefore the low levels of T3 during nonthyroidal illness and starvation have been interpreted as an attempt to save energy expenditure, and intervention is not required. However, this remains controversial and has been a debate for many years. In this chapter, the changes in thyroid hormone levels, the pathophysiology behind these changes, the diagnosis of intrinsic thyroid disease, and the currently available evidence whether these changes should or should not be corrected will be discussed (Box 3.1.5.1).

Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study

2020 ◽  
Vol 33 (5) ◽  
pp. 653-659
Author(s):  
Jia Song ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Jiaying Dou ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Thyroid Hormone ◽  
Observational Study ◽  
Hospital Mortality ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Threshold Value ◽  
Nonthyroidal Illness ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.

Nonthyroidal illness syndrome in ST-elevation myocardial infarction treated with mechanical revascularization

2012 ◽  
Vol 158 (1) ◽  
pp. 103-104 ◽  
Author(s):  
Chiara Lazzeri ◽  
Andrea Sori ◽  
Claudio Picariello ◽  
Marco Chiostri ◽  
Gian Franco Gensini ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Nonthyroidal Illness ◽  
St Elevation

Nonthyroidal Illness Syndrome

2013 ◽  
Vol 47 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Song Liu ◽  
Jianan Ren ◽  
Yunzhao Zhao ◽  
Gang Han ◽  
Zhiwu Hong ◽  
...  
Keyword(s):  
Nonthyroidal Illness

Stimulation of Thyroid Adenylate Cyclase Activity in Sera of Patients with Nonthyroidal Illness

1986 ◽  
pp. 385-389
Author(s):  
F. Kakezono ◽  
S. Yamashita ◽  
N. Yokoyama ◽  
S. Morita ◽  
S. Okamoto ◽  
...  
Keyword(s):  
Adenylate Cyclase ◽  
Cyclase Activity ◽  
Adenylate Cyclase Activity ◽  
Nonthyroidal Illness ◽  
Stimulation Of

scholarly journals 966 The Nonthyroidal Illness Syndrome in Septic Children

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A276-A276
Author(s):  
M. Neamtu ◽  
L. Dobrota ◽  
M. Neamtu ◽  
C. B. Neamtu ◽  
F. Diac
Keyword(s):  
Nonthyroidal Illness

Free thyroxine assessed with three assays in sera of patients with nonthyroidal illness and of subjects with abnormal concentrations of thyroxine-binding proteins

1993 ◽  
Vol 39 (8) ◽  
pp. 1668-1674 ◽  
Author(s):  
R Docter ◽  
H van Toor ◽  
E P Krenning ◽  
M de Jong ◽  
G Hennemann
Keyword(s):  
Blood Donors ◽  
Reference Range ◽  
Equilibrium Dialysis ◽  
Free Thyroxine ◽  
Serum Samples ◽  
Nonthyroidal Illness ◽  
Nonesterified Fatty Acids ◽  
Thyroxine Binding Globulin ◽  
Control Value ◽  
The Mean

Abstract Three methods for estimating free thyroxine (FT4) in serum were studied: equilibrium dialysis, the SPAC-ET FT4 radioimmunoassay kit, and the Amerlite MAB FT4 luminometric assay. Serum samples from 10 subjects with above-normal thyroxine-binding globulin (TBG), 6 with low TBG, 30 with familial dysalbuminemic hyperthyroxinemia (FDH), 13 with nonesterified fatty acids (NEFA) concentrations in serum &gt; 1.0 mmol/L, and 178 patients with various degrees of nonthyroidal illness (NTI) were measured and compared with samples from 42 euthyroid blood donors. The Amerlite MAB FT4 assay compared well with equilibrium dialysis, whereas the SPAC-ET assay averaged 40% lower. All three assays were not influenced by changes in TBG and showed no or only little changes in the presence of NEFA. Mean FT4 values in the FDH samples were somewhat higher than in controls when measured with the SPAC-ET assay, about equal with equilibrium dialysis, and somewhat below the mean control value with the Amerlite MAB FT4 assay, although individual results were within the control reference range. In NTI patients, no FT4 values were below the control reference range by the Amerlite MAB FT4 assay, 4 of 178 were below this range by equilibrium dialysis, and 1 of 178 was below this range by the SPAC-ET assay. In all assays a large proportion of the NTI samples showed FT4 values above the control reference range, a result that will interfere with the efficacy of these assays for assessing thyroid function in NTI patients.

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