Euthyroid sick syndrome natural history, complications and prognosis

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

Overview

• If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
• Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
• Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

If left untreated, patients with euthyroid sick syndrome may either progress to develop hypothyroidism or resolve spontaneously with correction of underlying condition.

• If the patient is treated of underlying condition, thyroid hormones gradually return to normal level and symptoms of hypothyroidism subside.
• If underlying condition is not corrected, the thyroid hormone levels starts to drop after 2-3 weeks of initial illness. The symptoms of hypothyroidism may take some additional weeks before they start to appear.

Complications

The complications of euthyroid sick syndrome depends upon other organ systems involved and underlying disease(s). The general complications of hypothyroidism as seen in euthyroid sick syndrome include hypothermia, bradycardia, heart failure, dyspnea, confusion, apathy and psychosis. Laboratory finding will show increased levels of cholesterol and triglycerides. In addition, patients will have features of organs system involved.

Prognosis

Depending on the extent of the underlying disease at the time of diagnosis, the prognosis may vary. Patients with low T3 levels may have a longer hospital stay. Mortality rate is as high as 80% when serum T4 value is <3 mcg/dL.