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
Related Articles
- EP ID EP336143
- DOI 10.21304/2017.0404.00213
- Views 88
- Downloads 0
Feasibility of initiating enteral nutrition support with first 24 hours of congenital heart repairs in neonates and Infants and its impact on outcomes following surgery : A Pilot study
.
Impact Of Resuscitation With 20% Versus 5% Albumin In Outcome Of Severe Dengue: A Prospective Observational Study
.
Serum sodium and potassium levels as prognostic indicators in pediatric diabetic ketoacidosis
Diabetic ketoacidosis (DKA),a common emergency encountered in children is characterized by deranged acid-base status and a myriad of electrolyte disturbances.
Recurrent Guillain-Barre Syndrome in a pediatric patient - Residual opthalmoplegia that recovered with IV immunoglobulins : A case report
Guillain-Barré syndrome(GBS) is the most common and most severe acute paralytic neuropathy, with about 1,00,000 people developing the disorder every year worldwide. Under the umbrella term of Guillain-Barré syndrome are...
Best Evidence
.