Euthyroid sick syndrome

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List of terms related to Euthyroid sick syndrome

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords: sick euthyroid syndrome; non-thyroidal illness syndrome; low T3 low T4 syndrome

Euthyroid sick syndrome
ICD-10	E07.8
ICD-9	790.94
MeSH	D005067

Overview

Euthyroid sick syndrome is a thyroid hormone disorder where the levels of T3 (triiodothyronine) and/or T4 (thyroxine) are at unusual levels, but the thyroid gland does not appear to be dysfunctional. Euthyroid sick syndrome is seen in conditions of starvation and critical illness such as sepsis, surgery, and bone marrow transplantation.

Pathophysiology

T3 is the biologically active form of thyroid hormone. Normally most of the T3 is produced by peripheral deiodination of circulating T4 by the enzyme 5’-monodeiodinase. In euthyroid sick syndrome there occurs inhibition of the enzyme 5΄-deiodinase and it leads to decrease conversion of T4 to T3.

Differentiating Euthyroid sick syndrome from Other Diseases

Fasting, starvation, sepsis, trauma, cardiopulmonary bypass, malignancy, heart failure, hypothermia, myocardial infarction, chronic renal failure, cirrhosis, and diabetic ketoacidosis.

Treatment

Medical Therapy

Ill patients may have normal to low TSH depending on the spectrum of illness. Total T4 and T3 levels may be altered by binding protein abnormalities, and medications. Reverse T3 are generally increased signifying inhibition of normal Type 1 enzyme or reduced clearance of reverse T3. Measurement of free T4 and/or free T3 levels will be normal.

External links

• McIver B, Gorman C (1997). "Euthyroid sick syndrome: an overview". Thyroid. 7 (1): 125–32. PMID 9086580.

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