Euthyroid sick syndrome diagnostic criteria: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnosis of [[euthyroid]] sick syndrome is based on [[clinical]] presentation and [[thyroid function tests]]. An important part in diagnosing euthyroid sick syndrome is to be able to differentiate between other causes of [[hypothyroidism]] and [[euthyroid]] sick syndrome. The best initial test is [[Thyroid-stimulating hormone|TSH]], which in euthyroid sick syndrome can be low, normal, or elevated but not as high as it would be in [[hypothyroidism]]. Serum [[reverse T3]] is elevated from inhibition of 5' monodeiodinase(type I). Patient having severe underlying [[illness]], as in euthyroid sick syndrome have elevated levels of serum [[cortisol]] from underlying [[Stress (medicine)|stress]] whereas patients of [[hypothyroidism]] have low serum [[cortisol]] from associated [[Hypothalamic|hypothalmic]]/[[Pituitary gland|pituitary]] abnormality. | The diagnosis of [[euthyroid]] sick syndrome is based on [[clinical]] presentation and [[thyroid function tests]]. An important part in diagnosing euthyroid sick syndrome is to be able to differentiate between other causes of [[hypothyroidism]] and [[euthyroid]] sick syndrome. Although the diagnosis of hypothyroidism is mainly a laboratory diagnosis, the coexisting conditions and wide variation in clinical presentation may make the diagnosis difficult. The best initial test is [[Thyroid-stimulating hormone|TSH]], which in euthyroid sick syndrome can be low, normal, or elevated but not as high as it would be in [[hypothyroidism]]. Serum [[reverse T3]] is elevated from inhibition of 5' monodeiodinase(type I). Patient having severe underlying [[illness]], as in euthyroid sick syndrome have elevated levels of serum [[cortisol]] from underlying [[Stress (medicine)|stress]] whereas patients of [[hypothyroidism]] have low serum [[cortisol]] from associated [[Hypothalamic|hypothalmic]]/[[Pituitary gland|pituitary]] abnormality. Recent evidence has shown that subclinical hypothyroidism may have various consequences, such as [[hyperlipidemia]], increased risk of [[cardiovascular disease]] (even [[heart failure|heart failure)]], [[somatic]] and [[neuromuscular]] symptoms, [[infertility]], and other complications.<ref name="pmid8371604">{{cite journal |vauthors=O'Brien T, Dinneen SF, O'Brien PC, Palumbo PJ |title=Hyperlipidemia in patients with primary and secondary hypothyroidism |journal=Mayo Clin. Proc. |volume=68 |issue=9 |pages=860–6 |year=1993 |pmid=8371604 |doi= |url=}}</ref><ref name="pmid7605150">{{cite journal |vauthors=Diekman T, Lansberg PJ, Kastelein JJ, Wiersinga WM |title=Prevalence and correction of hypothyroidism in a large cohort of patients referred for dyslipidemia |journal=Arch. Intern. Med. |volume=155 |issue=14 |pages=1490–5 |year=1995 |pmid=7605150 |doi= |url=}}</ref><ref name="pmid18415684">{{cite journal |vauthors=Lania A, Persani L, Beck-Peccoz P |title=Central hypothyroidism |journal=Pituitary |volume=11 |issue=2 |pages=181–6 |year=2008 |pmid=18415684 |doi=10.1007/s11102-008-0122-6 |url=}}</ref> | ||
==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The diagnosis of euthyroid sick syndrome is based on clinical presentation and thyroid function tests. An important part in diagnosing euthyroid sick syndrome is to be able to differentiate between other causes of hypothyroidism and euthyroid sick syndrome. Although the diagnosis of hypothyroidism is mainly a laboratory diagnosis, the coexisting conditions and wide variation in clinical presentation may make the diagnosis difficult. The best initial test is TSH, which in euthyroid sick syndrome can be low, normal, or elevated but not as high as it would be in hypothyroidism. Serum reverse T3 is elevated from inhibition of 5' monodeiodinase(type I). Patient having severe underlying illness, as in euthyroid sick syndrome have elevated levels of serum cortisol from underlying stress whereas patients of hypothyroidism have low serum cortisol from associated hypothalmic/pituitary abnormality. Recent evidence has shown that subclinical hypothyroidism may have various consequences, such as hyperlipidemia, increased risk of cardiovascular disease (even heart failure), somatic and neuromuscular symptoms, infertility, and other complications.[1][2][3]
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
- The diagnosis of [disease name] is based on the [criteria name] criteria, which include
- [criterion 1]
- [criterion 2]
- [criterion 3]
- The diagnosis of [disease name] is based on the [definition name] definition, which includes
- [criterion 1]
- [criterion 2]
- [criterion 3]
OR
- There are no established criteria for the diagnosis of [disease name].
References
- ↑ O'Brien T, Dinneen SF, O'Brien PC, Palumbo PJ (1993). "Hyperlipidemia in patients with primary and secondary hypothyroidism". Mayo Clin. Proc. 68 (9): 860–6. PMID 8371604.
- ↑ Diekman T, Lansberg PJ, Kastelein JJ, Wiersinga WM (1995). "Prevalence and correction of hypothyroidism in a large cohort of patients referred for dyslipidemia". Arch. Intern. Med. 155 (14): 1490–5. PMID 7605150.
- ↑ Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.