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: Akshun Kalia M.B.B.S.[2]
Overview
If left untreated, patients with euthyroid sick syndrome may progress to develop hypothyroidism or resolve spontaneously with correction of underlying condition. 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. 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, myopathy, confusion, apathy and psychosis. Laboratory finding will show increased levels of cholesterol and triglycerides. In addition, patients will have features of organs system involved. The prognosis varies and depends upon extent of the underlying disease at the time of diagnosis. 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.
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.[1][2]
References
- ↑ Liu J, Wu X, Lu F, Zhao L, Shi L, Xu F (2016). "Low T3 syndrome is a strong predictor of poor outcomes in patients with community-acquired pneumonia". Sci Rep. 6: 22271. doi:10.1038/srep22271. PMC 4772089. PMID 26928863.
- ↑ Slag MF, Morley JE, Elson MK, Crowson TW, Nuttall FQ, Shafer RB (1981). "Hypothyroxinemia in critically ill patients as a predictor of high mortality". JAMA. 245 (1): 43–5. PMID 7431627.