Differentiating Euthyroid sick syndrome from other diseases: Difference between revisions
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==Differentiating Euthyroid sick syndrome from other Diseases== | ==Differentiating Euthyroid sick syndrome from other Diseases== | ||
== Differentiating different causes of hypothyroidism == | == Differentiating different causes of hypothyroidism == | ||
Various kinds of hypothyroidism can be differentiated from each other on the basis of history and symptoms and laboratory findings: | Various kinds of hypothyroidism can be differentiated from each other on the basis of history and symptoms and laboratory findings:<ref name="pmid19949140">{{cite journal |vauthors=McDermott MT |title=In the clinic. Hypothyroidism |journal=Ann. Intern. Med. |volume=151 |issue=11 |pages=ITC61 |year=2009 |pmid=19949140 |doi=10.7326/0003-4819-151-11-200912010-01006 |url=}}</ref><ref name="pmid11836274">{{cite journal |vauthors=Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE |title=Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) |journal=J. Clin. Endocrinol. Metab. |volume=87 |issue=2 |pages=489–99 |year=2002 |pmid=11836274 |doi=10.1210/jcem.87.2.8182 |url=}}</ref><ref name="pmid18177256">{{cite journal |vauthors=Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR |title=Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002) |journal=Thyroid |volume=17 |issue=12 |pages=1211–23 |year=2007 |pmid=18177256 |doi=10.1089/thy.2006.0235 |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief:
Overview
Fasting, starvation, sepsis, trauma, cardiopulmonary bypass, malignancy, heart failure, hypothermia, myocardial infarction, chronic renal failure, cirrhosis, and diabetic ketoacidosis.
- [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
- [Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Differentiating Euthyroid sick syndrome from other Diseases
Differentiating different causes of hypothyroidism
Various kinds of hypothyroidism can be differentiated from each other on the basis of history and symptoms and laboratory findings:[1][2][3]
Disease | History and symptoms | Laboratory findings | Additional findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Fever | Goiter | Pain | TSH | Free T4 | T3 | T3RU | Thyroglobin | TRH | TPOAb | |||
Euthyroid sick syndrome | ||||||||||||
Primary hypothyroidism | Autoimmune | + | +/-
Diffuse |
- | ↑ | ↓ | N/↓ | Normal | N/↑ | Normal | ↑ |
|
Thyroiditis | + | +/- | + | ↑ | ↓ | Normal | Normal | N/↑ | Normal | Normal |
| |
Others | - | +/- | - | ↑ | ↓ | Normal | Normal | N/↑ | Normal | Normal |
| |
Transient hypothyroidism | +/- | - | +/- | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal |
| |
Subclinical hypothyroidism | - | - | - | ↑ | Normal | Normal | Normal | ↑ | Normal | N/↑ |
| |
Central Hypothyroidism | Pituitary | + | - | - | N/↓ | N/↓ | N/↓ | ↓ | Normal | Normal | Normal |
|
Hypothalamus | + | - | - | ↑ | Normal | ↓ | Normal |
| ||||
Resistance to TSH/TRH | - | - | - | ↑ | N/↓ | N/↓ | Normal | Normal | ↑/↓ | Normal |
|
References
- ↑ McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.
- ↑ Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE (2002). "Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III)". J. Clin. Endocrinol. Metab. 87 (2): 489–99. doi:10.1210/jcem.87.2.8182. PMID 11836274.
- ↑ Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.