Euthyroid sick syndrome overview: Difference between revisions
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==Overview== | ==Overview== | ||
Euthyroid sick syndrome is a [[thyroid hormone]] disorder where the levels of T3 ([[triiodothyronine]]) and/or T4 ([[thyroxine]]) are at unusual levels, in the setting of a nonthyroidal [[illness]]. Thyroid hormones play a major role in the metabolism, growth and maturation of the human body. [[Euthyroid]] sick [[syndrome]] is seen in conditions of [[starvation]] and [[critical illness]] such as [[sepsis]], [[surgery]], [[Physical trauma|severe trauma]], [[burns]], [[metabolic disorders]], [[bone marrow transplantation]], and [[malignancy]]. During these [[Stress (medicine)|stress]] conditions, there occurs [[hypermetabolism]], increased energy expenditure, [[hyperglycemia]], and muscle loss. It is speculated, that the body in order to contain this [[hypermetabolism]] induces some degree of [[hypothyroidism]] by inhibiting deiodination of [[T4]] to [[Triiodothyronine|T3]] by the enzyme 5’-monodeiodinase. This is an adaptive process by which the body prevents further [[muscle]] and [[calorie]] loss. [[Euthyroid]] sick syndrome presents with low serum [[T3]]. Depending upon the severity and duration of the [[Stress (medicine)|stress]] inducing condition, the thyroid-stimulating hormone([[Thyroid-stimulating hormone|TSH]]), [[thyroxine]] (T4), and [[free T4]] (FT4) are affected in variable proportions.<ref name="pmid9712558">{{cite journal |vauthors=Plank LD, Connolly AB, Hill GL |title=Sequential changes in the metabolic response in severely septic patients during the first 23 days after the onset of peritonitis |journal=Ann. Surg. |volume=228 |issue=2 |pages=146–58 |year=1998 |pmid=9712558 |pmc=1191454 |doi= |url=}}</ref><ref name="pmid21724536">{{cite journal |vauthors=Economidou F, Douka E, Tzanela M, Nanas S, Kotanidou A |title=Thyroid function during critical illness |journal=Hormones (Athens) |volume=10 |issue=2 |pages=117–24 |year=2011 |pmid=21724536 |doi= |url=}}</ref><ref name="pmid30020">{{cite journal |vauthors=Harris AR, Fang SL, Vagenakis AG, Braverman LE |title=Effect of starvation, nutriment replacement, and hypothyroidism on in vitro hepatic T4 to T3 conversion in the rat |journal=Metab. Clin. Exp. |volume=27 |issue=11 |pages=1680–90 |year=1978 |pmid=30020 |doi= |url=}}</ref> | |||
==Historical Perspective== | ==Historical Perspective== | ||
Revision as of 14:20, 4 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Euthyroid sick syndrome is a thyroid hormone disorder where the levels of T3 (triiodothyronine) and/or T4 (thyroxine) are at unusual levels, in the setting of a nonthyroidal illness. Thyroid hormones play a major role in the metabolism, growth and maturation of the human body. Euthyroid sick syndrome is seen in conditions of starvation and critical illness such as sepsis, surgery, severe trauma, burns, metabolic disorders, bone marrow transplantation, and malignancy. During these stress conditions, there occurs hypermetabolism, increased energy expenditure, hyperglycemia, and muscle loss. It is speculated, that the body in order to contain this hypermetabolism induces some degree of hypothyroidism by inhibiting deiodination of T4 to T3 by the enzyme 5’-monodeiodinase. This is an adaptive process by which the body prevents further muscle and calorie loss. Euthyroid sick syndrome presents with low serum T3. Depending upon the severity and duration of the stress inducing condition, the thyroid-stimulating hormone(TSH), thyroxine (T4), and free T4 (FT4) are affected in variable proportions.[1][2][3]
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Euthyroid sick syndrome from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
CT scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Plank LD, Connolly AB, Hill GL (1998). "Sequential changes in the metabolic response in severely septic patients during the first 23 days after the onset of peritonitis". Ann. Surg. 228 (2): 146–58. PMC 1191454. PMID 9712558.
- ↑ Economidou F, Douka E, Tzanela M, Nanas S, Kotanidou A (2011). "Thyroid function during critical illness". Hormones (Athens). 10 (2): 117–24. PMID 21724536.
- ↑ Harris AR, Fang SL, Vagenakis AG, Braverman LE (1978). "Effect of starvation, nutriment replacement, and hypothyroidism on in vitro hepatic T4 to T3 conversion in the rat". Metab. Clin. Exp. 27 (11): 1680–90. PMID 30020.