Euthyroid sick syndrome classification
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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
Euthyroid sick syndrome may be classified according to the level of thyroid hormones and the severity of the underlying disease into mild, moderate, severe, and recovery phase.
Classification
Euthyroid sick syndrome may be classified according to the level of thyroid hormones and the severity of the underlying disease. Depending upon the severity and duration of the stress inducing condition, the thyroid-stimulating hormone(TSH), thyroxine (T4), and free T4 (FT4) are affected in variable proportions. The drop in levels of T3 and T4 are more with more severe illnesses. On the basis of thyroid hormone levels euthyroid sick syndrome can be categorized into:[1][2][3][4][5]
- Mild
- Moderate
- Severe
- Recovery
| Euthyroid sick syndrome | T3
(80-180 ng/dl) |
T4
(4.6-12 ug/dl) |
FT4
(0.7-1.9 ng/dl) |
TSH
(0.4 to 4.0mIU/L) |
Reverse T3
(90 to 350pg/mL) |
|---|---|---|---|---|---|
| Mild euthyroid sick syndrome | ↓ | N | N | N | ↑ |
| Moderate euthyroid sick syndrome | ↓ | N | N/↓ | N/↑ | ↑ |
| Severe euthyroid sick syndrome | ↓ | ↓ | N/↓ | ↓ | ↑ |
| Recovery | N/↓ | N | N | N | N/↑ |
References
- ↑ Golombek SG (2008). "Nonthyroidal illness syndrome and euthyroid sick syndrome in intensive care patients". Semin. Perinatol. 32 (6): 413–8. doi:10.1053/j.semperi.2008.09.010. PMID 19007679.
- ↑ Frączek MM, Gackowski A, Przybylik-Mazurek E, Nessler J (2016). "[The relation between the low T3 syndrome in the clinical course of myocardial infarction and heart failure]". Pol. Merkur. Lekarski (in Polish). 40 (240): 380–3. PMID 27403906.
- ↑ Van den Berghe G (2014). "Non-thyroidal illness in the ICU: a syndrome with different faces". Thyroid. 24 (10): 1456–65. doi:10.1089/thy.2014.0201. PMC 4195234. PMID 24845024.
- ↑ Murakami M (2012). "[Nonthyroidal illness (NTI)]". Nippon Rinsho (in Japanese). 70 (11): 2005–10. PMID 23214076.
- ↑ Lee S, Farwell AP (2016). "Euthyroid Sick Syndrome". Compr Physiol. 6 (2): 1071–80. doi:10.1002/cphy.c150017. PMID 27065175.