Euthyroid sick syndrome history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Patients of euthyroid sick syndrome present with serious [[illness]] and are [[febrile]] with [[hypermetabolism]]. In euthyroid sick syndrome the symptoms of the underlying condition may overlap with features of [[hypothyroidism]]. Generally it takes atleast 2-3 weeks for [[thyroid hormone]] levels to decline and symptoms of [[hypothyroidism]] takes even longer period for [[expression]]. 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> | Patients of euthyroid sick syndrome present with serious [[illness]] and are [[febrile]] with [[hypermetabolism]]. In euthyroid sick syndrome the symptoms of the underlying condition may overlap with features of [[hypothyroidism]]. Generally it takes atleast 2-3 weeks for [[thyroid hormone]] levels to decline and symptoms of [[hypothyroidism]] takes even longer period for [[expression]]. 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><ref name="pmid26071885">{{cite journal |vauthors=Fliers E, Bianco AC, Langouche L, Boelen A |title=Thyroid function in critically ill patients |journal=Lancet Diabetes Endocrinol |volume=3 |issue=10 |pages=816–25 |year=2015 |pmid=26071885 |pmc=4979220 |doi=10.1016/S2213-8587(15)00225-9 |url=}}</ref><ref name="pmid25305308">{{cite journal |vauthors=Carlé A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P |title=Hypothyroid symptoms and the likelihood of overt thyroid failure: a population-based case-control study |journal=Eur. J. Endocrinol. |volume=171 |issue=5 |pages=593–602 |year=2014 |pmid=25305308 |doi=10.1530/EJE-14-0481 |url=}}</ref><ref name="pmid25086165">{{cite journal |vauthors=Diaz A, Lipman Diaz EG |title=Hypothyroidism |journal=Pediatr Rev |volume=35 |issue=8 |pages=336–47; quiz 348–9 |year=2014 |pmid=25086165 |doi=10.1542/pir.35-8-336 |url=}}</ref><ref name="pmid25122491">{{cite journal |vauthors=Samuels MH |title=Psychiatric and cognitive manifestations of hypothyroidism |journal=Curr Opin Endocrinol Diabetes Obes |volume=21 |issue=5 |pages=377–83 |year=2014 |pmid=25122491 |pmc=4264616 |doi=10.1097/MED.0000000000000089 |url=}}</ref><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> | ||
The common symptoms and signs of clinical hypothyroidism are listed in the table below. The appearance of symptoms depends on the degree of hypothyroidism severity: | The common symptoms and signs of clinical hypothyroidism are listed in the table below. The appearance of symptoms depends on the degree of hypothyroidism severity: | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Patients of euthyroid sick syndrome present with serious illness and are febrile with hypermetabolism. In euthyroid sick syndrome the symptoms of the underlying condition may overlap with features of hypothyroidism. Generally it takes atleast 2-3 weeks for thyroid hormone levels to decline and symptoms of hypothyroidism takes even longer period for expression. 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][4][5][6][7][8]
The common symptoms and signs of clinical hypothyroidism are listed in the table below. The appearance of symptoms depends on the degree of hypothyroidism severity:
| Symptoms | Constituitional | HEENT | Neuromuscular | Other findings |
|---|---|---|---|---|
| More common |
|
|
| |
| Less common |
|
|
|
Physical Examination
Imaging Findings
Other Diagnostic Studies
In euthyroid sick syndrome the thyroid gland appears normal. Therefore, there is no role of thyroid uptake scan in euthyroid sick syndrome.
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.
- ↑ Fliers E, Bianco AC, Langouche L, Boelen A (2015). "Thyroid function in critically ill patients". Lancet Diabetes Endocrinol. 3 (10): 816–25. doi:10.1016/S2213-8587(15)00225-9. PMC 4979220. PMID 26071885.
- ↑ Carlé A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P (2014). "Hypothyroid symptoms and the likelihood of overt thyroid failure: a population-based case-control study". Eur. J. Endocrinol. 171 (5): 593–602. doi:10.1530/EJE-14-0481. PMID 25305308.
- ↑ Diaz A, Lipman Diaz EG (2014). "Hypothyroidism". Pediatr Rev. 35 (8): 336–47, quiz 348–9. doi:10.1542/pir.35-8-336. PMID 25086165.
- ↑ Samuels MH (2014). "Psychiatric and cognitive manifestations of hypothyroidism". Curr Opin Endocrinol Diabetes Obes. 21 (5): 377–83. doi:10.1097/MED.0000000000000089. PMC 4264616. PMID 25122491.
- ↑ McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.