Euthyroid sick syndrome causes: Difference between revisions
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{{Euthyroid sick syndrome}} | {{Euthyroid sick syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{Akshun}} | ||
==Overview== | ==Overview== | ||
Euthyroid sick syndrome can be caused by any serious [[illness]] which leads to increased level of [[cytokines]], decreased level of [[leptin]], [[Hypermetabolism|hyper-metabolism | Euthyroid sick syndrome can be caused by any serious [[illness]] which leads to increased level of [[cytokines]], decreased level of [[leptin]], [[Hypermetabolism|hyper-metabolism]], decreased [[protein]] synthesis and decreased level of thyroid-binding globulin. The conditions include [[sepsis]], [[malignancy]], [[physical trauma|trauma]], [[surgery]], [[burns]], [[bone marrow transplantation|bone marrow transplantation,]] [[metabolic disorders]], and other [[inflammatory]] conditions. | ||
==Causes== | ==Causes== | ||
Euthyroid sick syndrome can be caused by any serious [[illness]] which leads to increased level of [[cytokines]], decreased level of [[leptin]], [[Hypermetabolism|hyper-metabolism]], [[iodine]] containing [[contrast medium]], decreased [[protein]] synthesis and decreased level of | ===Common Causes=== | ||
Euthyroid sick syndrome can be caused by any serious [[illness]] which leads to increased level of [[cytokines]], decreased level of [[leptin]], [[Hypermetabolism|hyper-metabolism]], [[iodine]] containing [[contrast medium]], decreased [[protein]] synthesis and decreased level of [[TBG|thyroxin-binding globulin]]. The conditions include:<ref name="pmid26677087">{{cite journal |vauthors=Silva MH, Araujo MC, Diniz EM, Ceccon ME, Carvalho WB |title=Nonthyroidal illnesses syndrome in full-term newborns with sepsis |journal=Arch Endocrinol Metab |volume=59 |issue=6 |pages=528–34 |year=2015 |pmid=26677087 |doi=10.1590/2359-3997000000111 |url=}}</ref><ref name="pmid27403906">{{cite journal |vauthors=Frączek MM, Gackowski A, Przybylik-Mazurek E, Nessler J |title=[The relation between the low T3 syndrome in the clinical course of myocardial infarction and heart failure] |language=Polish |journal=Pol. Merkur. Lekarski |volume=40 |issue=240 |pages=380–3 |year=2016 |pmid=27403906 |doi= |url=}}</ref><ref name="pmid9591009">{{cite journal |vauthors=Girvent M, Maestro S, Hernández R, Carajol I, Monné J, Sancho JJ, Gubern JM, Sitges-Serra A |title=Euthyroid sick syndrome, associated endocrine abnormalities, and outcome in elderly patients undergoing emergency operation |journal=Surgery |volume=123 |issue=5 |pages=560–7 |year=1998 |pmid=9591009 |doi=10.1067/msy.1998.87238 |url=}}</ref> | |||
*[[Sepsis]] | *[[Sepsis]] | ||
*[[Malignancy]] | *[[Malignancy]] | ||
| Line 16: | Line 17: | ||
*[[Metabolic disorders]] | *[[Metabolic disorders]] | ||
*Other [[Inflammatory]] conditions | *Other [[Inflammatory]] conditions | ||
*Any major condition of | *Any major condition of: | ||
**[[Cardiovascular system]]: [[Myocardial infarction]] | **[[Cardiovascular system]]: [[Myocardial infarction]] | ||
**[[Respiratory system]] : [[Pneumonia]] | **[[Respiratory system]] : [[Pneumonia]] | ||
**[[Genitourinary system]]: [[Chronic renal failure]] | **[[Genitourinary system]]: [[Chronic renal failure]] | ||
**[[Gastrointestinal system]]: [[Cirrhosis]] | **[[Gastrointestinal system]]: [[Cirrhosis]] | ||
===Less Common Causes=== | |||
*The following table summarize the effect of various drugs on thyroid hormones level | *The following table summarize the effect of various drugs on thyroid hormones level: | ||
{| class="wikitable" | {| class="wikitable" | ||
! rowspan="2" |↓ Hormone secretion | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ Hormone secretion | ||
! rowspan="2" |↓ T4 | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ T4 | ||
! rowspan="2" |↓ TSH | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ TSH | ||
! rowspan="2" |↓ 5' monodeiodinase | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ 5' monodeiodinase | ||
! rowspan="2" |'''↑ Breakdown of''' | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |'''↑ Breakdown of''' | ||
'''thyroid hormones''' | '''thyroid hormones''' | ||
! colspan="2" |'''Thyroid binding globulin''' | ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |'''Thyroid binding globulin''' | ||
|- | |- | ||
!Increased | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Increased | ||
!Decreased | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Decreased | ||
|- | |- | ||
| | | | ||
*Lithium<br> | *[[Lithium]]<br> | ||
*Amiodarone | *[[Amiodarone]] | ||
| | | | ||
*Aluminum hydroxide <br> | *[[Aluminium hydroxide|Aluminum hydroxide]] <br> | ||
*Ferrous sulphate <br> | *[[Ferrous sulphate]] <br> | ||
*Sucralfate | *[[Sucralfate]] | ||
| | | | ||
*Dopamine<br> | *[[Dopamine]]<br> | ||
*Octreotide <br> | *[[Octreotide]] <br> | ||
*Glucocorticoids<br> | *[[Glucocorticoids]]<br> | ||
| | | | ||
*Propylthiouracil<br> | *[[Propylthiouracil]]<br> | ||
*Amiodarone<br> | *[[Amiodarone]]<br> | ||
*Propranolol (high dose) | *[[Propranolol]] (high dose) | ||
| | | | ||
*Phenobarbital<br> | *[[Phenobarbital]]<br> | ||
*Rifampin <br> | *[[Rifampin]] <br> | ||
*Phenytoin <br> | *[[Phenytoin]] <br> | ||
*Carbamazepine | *[[Carbamazepine]] | ||
| | | | ||
*Estrogens <br> | *[[Estrogens]] <br> | ||
*Tamoxifen <br> | *[[Tamoxifen]] <br> | ||
*Fluorouracil <br> | *[[Fluorouracil]] <br> | ||
*Methadone<br> | *[[Methadone]]<br> | ||
*Heroin | *[[Heroin]] | ||
| | | | ||
*Androgens<br> | *[[Androgens]]<br> | ||
*Anabolic steroids<br> | *[[Anabolic steroids]]<br> | ||
*Glucocorticoids <br> | *[[Glucocorticoids]] <br> | ||
*Furosemide <br> | *[[Furosemide]] <br> | ||
*Mefenamic acid<br> | *[[Mefenamic acid]]<br> | ||
*[[Salicylates]] | |||
*[ | |||
|} | |} | ||
==References== | ==References== | ||
Latest revision as of 20:34, 16 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
Euthyroid sick syndrome can be caused by any serious illness which leads to increased level of cytokines, decreased level of leptin, hyper-metabolism, decreased protein synthesis and decreased level of thyroid-binding globulin. The conditions include sepsis, malignancy, trauma, surgery, burns, bone marrow transplantation, metabolic disorders, and other inflammatory conditions.
Causes
Common Causes
Euthyroid sick syndrome can be caused by any serious illness which leads to increased level of cytokines, decreased level of leptin, hyper-metabolism, iodine containing contrast medium, decreased protein synthesis and decreased level of thyroxin-binding globulin. The conditions include:[1][2][3]
- Sepsis
- Malignancy
- Trauma
- Surgery
- Burns
- Bone marrow transplantation
- Metabolic disorders
- Other Inflammatory conditions
- Any major condition of:
Less Common Causes
- The following table summarize the effect of various drugs on thyroid hormones level:
| ↓ Hormone secretion | ↓ T4 | ↓ TSH | ↓ 5' monodeiodinase | ↑ Breakdown of
thyroid hormones |
Thyroid binding globulin | |
|---|---|---|---|---|---|---|
| Increased | Decreased | |||||
|
||||||
References
- ↑ Silva MH, Araujo MC, Diniz EM, Ceccon ME, Carvalho WB (2015). "Nonthyroidal illnesses syndrome in full-term newborns with sepsis". Arch Endocrinol Metab. 59 (6): 528–34. doi:10.1590/2359-3997000000111. PMID 26677087.
- ↑ Frączek MM, Gackowski A, Przybylik-Mazurek E, Nessler J (2016). "[The relation between the low T3 syndrome in the clinical course of myocardial infarction and heart failure]". Pol. Merkur. Lekarski (in Polish). 40 (240): 380–3. PMID 27403906.
- ↑ Girvent M, Maestro S, Hernández R, Carajol I, Monné J, Sancho JJ, Gubern JM, Sitges-Serra A (1998). "Euthyroid sick syndrome, associated endocrine abnormalities, and outcome in elderly patients undergoing emergency operation". Surgery. 123 (5): 560–7. doi:10.1067/msy.1998.87238. PMID 9591009.