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 76
- Downloads 0
Intracranial Pressure and its Monitoring: A review
.
PICU QUIZ (Pediatric Transplant)
.
Non-invasive Positive Pressure Ventilation in children
Respiratory problems are common in pediatric population and need advanced respiratory support in intensive care for various reasons. Mechanical ventilation is most important mode of therapy/support of modern era in inten...
Hemorrhagic Shock in Pediatric Trauma
Hemorrhagic shock is a preventable mortality in pediatric trauma. Assessment and management requires an understanding of the patho-physiogical processes specific to children. The key to successful management of hemorrhag...
Typhoid Fever presenting as Multi Organ Dysfunction Syndrome
A 6 year old girl presented with a history of fever for 3 weeks, headache and multifocal seizures for 4 days with altered sensorium. Clinical assessment was consistent with hypotensive shock and encephalopathy. Her IgM a...