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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]], 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 predisposes to:
**Increased level of cytokines
**Decreased level of leptin
**Hyper-metabolism
**Iodine containing contrast medium
**Decreased protein synthesis
**Decreased level of thyroid-binding globulin
*The following table summarize the effect of various drugs on thyroid hormones level.
{| class="wikitable"
!↓ Hormone secretion
!↓ T4
!↓ TSH
!↓ 5' monodeiodinase
!'''↑ Breakdown'''
!'''↑ TBG'''
!↓TBG
|-
|Lithium
Amiodarone
|Aluminum hydroxide 
Ferrous sulphate  Sucralfate
|Dopamine
Octreotide  Glucocorticoids
|Propylthiouracil
Amiodarone 
Propranolol (high dose)
|Phenobarbital
Rifampin
Phenytoin  Carbamazepine
|Estrogens
Tamoxifen
Fluorouracil    Methadone
Heroin
|Androgens
Anabolic steroids 
Glucocorticoids 
Furosemide 
Mefenamic acid  Salicylates
|}
* {| class="wikitable" !↓ Hormone secretion !↓ T4 |↓ TSH |↓ 5'monodeiodinase |'''↑ Breakdown''' |'''↑ TBG''' |↓TBG |- |Lithium Amiodarone |Aluminum hydroxide  Ferrous sulphate  Sucralfate |Dopamine Octreotide  Glucocorticoids |Propylthiouracil Amiodarone  Propranolol (high dose) |Phenobarbital Rifampin,  Phenytoin,  Carbamazepine |Estrogens Tamoxifen  Fluorouracil    Methadone  Heroin |Androgens Anabolic steroids  Glucocorticoids  Furosemide  Mefenamic acid  Salicylates |}
==Causes==
===Life-threatening Causes===
*Life-threatening causes of [symptom/manifestation] include [cause1], [cause2], and [cause3].
*[Cause] is a life-threatening cause of [disease].
===Common Causes===
===Common Causes===
[Disease name] may be caused by:
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>
*[cause1]
*[[Sepsis]]
*[cause2]
*[[Malignancy]]
*[cause3]
*[[Physical trauma|Trauma]]
*[[Surgery]]
*[[Burns]]
*[[Bone marrow transplantation]]
*[[Metabolic disorders]]
*Other [[Inflammatory]] conditions
*Any major condition of:
**[[Cardiovascular system]]: [[Myocardial infarction]]
**[[Respiratory system]] : [[Pneumonia]]
**[[Genitourinary system]]: [[Chronic renal failure]]
**[[Gastrointestinal system]]: [[Cirrhosis]]


*[Disease name] is caused by an infection with [pathogen name].
*[Pathogen name] is caused by [pathogen name].
===Less Common Causes===
===Less Common Causes===
Less common causes of [[disease name]] include:
*The following table summarize the effect of various drugs on thyroid hormones level:
*[cause1]
{| class="wikitable"
*[cause2]
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ Hormone secretion
*[cause3]
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ T4
 
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ TSH
===Genetic Causes===
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |↓ 5' monodeiodinase
*[Disease name] is caused by a mutation in the [gene name] gene.
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |'''↑ Breakdown of'''
 
'''thyroid hormones'''  
===Causes by Organ System===
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |'''Thyroid binding globulin'''
 
|-  
{| style="width:80%; height:100px" border="1"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Increased
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Decreased
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | No underlying causes
|-
|-
|
*[[Lithium]]<br> 
*[[Amiodarone]]
|
*[[Aluminium hydroxide|Aluminum hydroxide]] <br> 
*[[Ferrous sulphate]] <br> 
*[[Sucralfate]]
|
*[[Dopamine]]<br> 
*[[Octreotide]] <br> 
*[[Glucocorticoids]]<br> 
|
*[[Propylthiouracil]]<br>
*[[Amiodarone]]<br> 
*[[Propranolol]] (high dose)
|
*[[Phenobarbital]]<br> 
*[[Rifampin]] <br> 
*[[Phenytoin]] <br> 
*[[Carbamazepine]]
|
*[[Estrogens]] <br> 
*[[Tamoxifen]] <br> 
*[[Fluorouracil]] <br>   
*[[Methadone]]<br> 
*[[Heroin]]
|
*[[Androgens]]<br> 
*[[Anabolic steroids]]<br>   
*[[Glucocorticoids]] <br> 
*[[Furosemide]]  <br> 
*[[Mefenamic acid]]<br> 
*[[Salicylates]]
|}
|}
===Causes in Alphabetical Order===
List the causes of the disease in alphabetical order.
{{columns-list|3|
* Cause 1
* Cause 2
* Cause 3
* Cause 4
* Cause 5
* Cause 6
* Cause 7
* Cause 8
* Cause 9
* Cause 10
}}


==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]

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

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.

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