Sick Euthyroid Syndrome: A Myth or Reality

Apply

Sick Euthyroid Syndrome: A Myth or Reality

Journal Title: Journal Of Pediatric Critical Care - Year 2017, Vol 4, Issue 4

Abstract

Altered thyroid function in non-thyroidal illness(NTI) is a well-recognized fi nding. The term euthyroid sick syndrome (SES) identifi es abnormalities in thyroid function observed in patients with systemic nonthyroidal illnesses (NTIs). SES being most common endocrine change seen in critically ill patients, is characterized by low triiodothyronine (T3), low or normal thyroxine (T4) and normal thyroid stimulating hormone (TSH). The extent of SES is associated with prognosis, but no proof exists for causality of this association. T3 levels refl ect the patient’s clinical status, T4 levels can predict survival. Initially, SES is a consequence of the acute phase response to systemic illness and macronutrient restriction, which might be benefi cial. Pathogenesis of SES in long term critical illness is more complex and includes suppression of hypothalamic thyrotropin-releasing hormone, accounting for persistently reduced secretion of thyroid-stimulating hormone despite low plasma thyroid hormone. Distinguishing between SES and other primary thyroid disorders, can be diffi cult in ICU setting. Clinical benefi ts of supplementing thyroid hormone in SES has not been answered adequately. No evidence-based consensus or guideline advocates thyroid hormone treatment of SES at present.

Authors and Affiliations

Vinayak K. Patki, Aniket Kumbhojkar, Praveen Khilnani

Keywords

EP ID EP336143
DOI 10.21304/2017.0404.00213
Views 65
Downloads 0