Euthyroid sick syndrome history and symptoms

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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.

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	Fatigue Cold intolerance Decreased sweating Hypothermia Coarse skin Weight gain	Hoarseness Goiter Fullness in the throat and neck	Depression Emotional lability Attention deficit	Macroglossia Obstructive sleep apnea Paresthesia Nerve entrapment syndromes (carpal tunnel syndrome) Blurred vision (central hypothyroidism)
Less common	Puffiness Hair loss Constipation Fever If accompanied by thyroiditis	Sore throat Periorbital edema	Slowed speech and movements	Pituitary hyperplasia followed by hyperprolactinemia Ataxia Myxedema coma (with non-pitting edema) Cardiomegaly Pericardial effusion Ascites Hyperlipidemia Galactorrhea Infertility

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.

History and Symptoms

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.

• The majority of patients with [disease name] are asymptomatic.

OR

• The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
• Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. 

History

Patients with [disease name]] may have a positive history of:

• [history finding 1]
• [history finding 2]
• [history finding 3]