352 patients were firstly diagnosed as basedow in the Army Central hospital 108 during 1996- 1997 participated to a study. The patients were classified according to the age groups, the types of changing the T3 and T4. The comparison of the level of T3 and T4 with the clinical diagnosis has shown that the level of T3 and T4 were an important criteria to monitor the progress of the disease, evaluate the normalization of the thyroid and help the indication for surgery.
Thyroid Hormones ; Euthyroid Sick Syndromes

Critical illness can be associated with transient alterations in circulating thyroid hormone concentrations, indicating the presence of non-thyroidal illness (NTI). NTI is well described in humans, but there are few reports on its occurrence and prognostic significance in dogs. This retrospective study assessed the occurrence of NTI in a population of dogs with systemic inflammatory response syndrome (SIRS) and investigated its association with disease severity (APPLE(fast) scores). A total of 41 SIRS dogs were included and were divided by SIRS origin (non-septic SIRS, n = 10; septic SIRS, n = 41) and final outcome (survivors, n = 37; non-survivors, n = 4). Healthy, age-matched dogs (n = 15) were included as controls. Serum thyroid hormone levels including total T3, free T3, total T4, and reverse T3 were measured upon admission. Compared to controls, there were significant changes in serum thyroid hormone concentrations in SIRS dogs, suggesting the presence of NTI. Septic SIRS dogs had higher APPLE(fast) scores and lower serum thyroid hormones concentrations than those in non-septic SIRS and control dogs. In conclusion, NTI was frequent in dogs with SIRS and may be associated with the presence of sepsis or high illness severity.
Animals ; Critical Illness* ; Dogs* ; Euthyroid Sick Syndromes ; Humans ; Retrospective Studies* ; Sepsis ; Systemic Inflammatory Response Syndrome* ; Thyroid Gland* ; Thyroid Hormones*

BACKGROUND: Critical illness that requires major surgery is often associated with non-thyroidal illness syndrome (NTIS). The characteristic feature of NTIS is low serum triiodothyronine (T3) levels, and in severe illness, the levels of serum thyroxine (T4) are also low in the absence of a rise in thyroid stimulating hormone (TSH). However, little is known about the changes in thyroid hormones during and after liver transplantation (LT). This study was conducted in order to evaluate the intra- or postoperative changes in thyroid hormones. METHODS: Twenty-two patients who underwent LT were enrolled. Serum levels of triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), free T3 (FT3) and free T4 (FT4) were measured immediately after the induction of anesthesia (T1), at the end of the anhepatic period (T2), at the end of the surgical procedure (T3), and at 24 hours (T4) and 120 hours postoperatively (T5). RESULTS: The mean levels of T3, T4, FT3, FT4 and TSH were significantly decreased throughout the study when compared with the T1 value. The mean levels of T3, T4 FT3 and TSH were below the normal range from T2, T4 and T5. CONCLUSIONS: We suggest that LT may induce NTIS by at least postoperative day 5. In the future, longer follow-up studies, and the effects of thyroid hormones on the prognosis and determination of the advantages and disadvantages of T3 replacement therapy to these patients will be required.
Anesthesia ; Critical Illness ; Euthyroid Sick Syndromes ; Humans ; Liver Transplantation* ; Prognosis ; Reference Values ; Thyroid Hormones* ; Thyrotropin ; Thyroxine ; Triiodothyronine

OBJECTIVE: To study the incidence rate of non-thyroidal illness syndrome (NTIS) in critically ill children with or without sepsis and the association of NTIS with interleukin-6 (IL-6) and interleukin-10 (IL-10). METHODS: A retrospective analysis was performed on the medical data of 97 children with sepsis (sepsis group) and 80 non-sepsis children with bacterial infection (non-sepsis group). The correlations of IL-6 and IL-10 with the thyroid function parameters triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were analyzed. RESULTS: There were no significant differences in age and sex between the sepsis and non-sepsis groups (P>0.05). Compared with the non-sepsis group, the sepsis group had a significantly higher Sequential Organ Failure Assessment score, a significantly longer length of hospital stay, and a significantly higher rate of use of ventilator (P<0.05). As for inflammation markers, the sepsis group had significantly higher levels of C-reactive protein, procalcitonin, and IL-6 than the non-sepsis group (P<0.05). As for thyroid function parameters, the sepsis group had significantly lower levels of T3, T4, free T3, free T4, and TSH than the non-sepsis group (P<0.05). Compared with the non-sepsis group, the sepsis group had significantly higher incidence rates of NTIS, low T3 and T4, and low TSH (P<0.001). The correlation analysis revealed that IL-6 level was not correlated with T3, T4, and TSH levels in children with or without sepsis (P>0.05), but the pooled analysis of the two groups showed that IL-6 level was negatively correlated with T3 and T4 levels (P<0.001). CONCLUSIONS Children with sepsis have a higher incidence rate of NTIS than those without sepsis. The high level of IL-6 may be associated with the development of NTIS.
Child ; Critical Illness ; Euthyroid Sick Syndromes ; Humans ; Interleukin-10/blood* ; Interleukin-6/blood* ; Retrospective Studies ; Sepsis ; Thyrotropin ; Thyroxine

PURPOSE: We compared thyroid hormone profiles in children with nephrotic syndrome (NS) during the nephrotic phase and after remission. METHODS: This study included 31 pediatric NS patients. The thyroid hormone profiles included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4. RESULTS: Of the 31 patients, 16 (51.6%) showed abnormal thyroid hormone profiles: 6 had overt hypothyroidism, 8 had subclinical hypothyroidism, and 2 had low T3 syndrome. The mean serum T3, T4, and free T4 levels in the nephrotic phase and after remission were 82.37±23.64 and 117.88±29.49 ng/dL, 5.47±1.14 and 7.91±1.56 µg/dL, and 1.02±0.26 and 1.38±0.23 ng/dL, respectively; the levels were significantly lower in the NS nephrotic phase (P=0.0007, P<0.0001, and P=0.0002). The mean serum TSH levels during the nephrotic phase and after remission were 8.05±3.53 and 4.08±2.05 µIU/ mL, respectively; they were significantly higher in the nephrotic phase (P=0.0005). The urinary protein/ creatinine ratio during the nephrotic phase was significantly correlated with serum T3, T4, and free T4 levels (r=-0.5995, P=0.0032; r=-0.5797, P=0.0047; r=-0.5513, P=0.0078) as well as with TSH levels (r=0.5022, P=0.0172). A significant correlation was found between serum albumin and serum T3 levels during the nephrotic phase (r=0.5385, P=0.0018) but not between serum albumin and T4, TSH, or free T4 levels. These significant correlations all disappeared after remission. CONCLUSION: Abnormal thyroid hormone profile findings were observed in 51.6% of pediatric patients with NS. Thyroid hormone levels normalized after remission, regardless of levothyroxine therapy.
Child ; Creatinine ; Euthyroid Sick Syndromes ; Humans ; Hypothyroidism ; Nephrotic Syndrome ; Serum Albumin ; Thyroid Gland ; Thyroid Hormones ; Thyrotropin ; Thyroxine ; Triiodothyronine

Significant illnesses or a major trauma including spinal cord injury can induce the changes of thyroid hormone metabolism, leading to the findings of "Euthyroid Sick Syndrome(ESS)". The physicians should be aware of these changes in order to interpret thyroid function test correctly after the spinal cord injury. We report three cases of ESS after the spinal cord injury. On a routine evaluation, they showed a low serum T3 level, and the T3 level returned to the normal range on a follow up study without any specific treatment.
Euthyroid Sick Syndromes* ; Follow-Up Studies ; Metabolism ; Reference Values ; Spinal Cord Injuries* ; Spinal Cord* ; Thyroid Function Tests ; Thyroid Gland

Euthyroid Sick Syndromes ; blood ; etiology ; Female ; Gestational Age ; Humans ; Hypothyroidism ; blood ; etiology ; Infant, Newborn ; Infant, Premature ; Male ; Risk Factors ; Sex Factors ; Thyronines ; blood ; Triiodothyronine ; blood

OBJECTIVETo investigate the therapeutic effect of low-dose thyroxin in elderly patients with refractory heart failure (RHF) and euthyroid sick syndrome (ESS).

METHODSFifty-four elderly patients with RHF and ESS were randomized into conventional treatment group (n=32) and L-thyroxine group with additional oral L-thyroxine at the daily dose of 6.25-25 microg (n=22). The changes in the plasma levels of brain natriuretic peptides (BNP), left ventricular ejection fraction (LVEF), and cardiac function (NYHA level) of the two groups were compared after 1 month of treatment.

RESULTSFive patients receiving conventional treatment died due to severe arrhythmia during the treatment, and in the other 27 patients, the levels of plasma BNP, LVEF, and cardiac function showed no significant improvements after 1 month of treatment (P>0.01). In L-thyroxine group, no death or severe arrhythmia occurred, and the levels of plasma BNP, LVEF, and cardiac function were significantly improved after the treatment (P<0.01). No thyrotoxicosis occurred during the administration of L-thyroxine in the latter group.

CONCLUSIONLow-dose L-thyroxine in addition to the conventional treatments may enhance the therapeutic effect in elderly patients with RHF and ESS.

Aged ; Aged, 80 and over ; Chronic Disease ; Drug Therapy, Combination ; Euthyroid Sick Syndromes ; complications ; drug therapy ; Female ; Heart Failure ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Thyroxine ; administration & dosage

BACKGROUND: Autoimmune thyroid diseases have been shown to occur in association with connective tissue disorders. This study was undertaken to elucidate the prevalence of thyroid autoantibodies and thyroid dysfunction in Korean patients with rheumatoid arthritis (RA). METHODS: We have compared the prevalence of thyroid autoantibodies in 108 RA patients with 81 age-matched controls. Antimicrosomal antibody (AMA) and antithyroglobulin antibody (ATA) were measured by passive hemagglutinin assay. T3, T4, Free T4, and TSH were measured by chemiluminescence method. Rheumatoid factor was measured by nephelometry. Statistical analysis was performed by chi-square, Fisher's exact test, and Pearson correlation test. RESULTS: 1) The presence of AMA/ATA in patients with RA was significantly higher (28.7%/26.7% in 108 patients) than that of controls (11.1%/9.9% in 81 controls). The positive rates of AMA/ATA in female patients were also higher (28.9%/28.9% in 97 patients) than those of female controls (15.5%/12.1% in 58 controls). 2) Thirty three (17.6%) of 187 patients with RA had the abnormalities of thyroid function; 14 (7.5%) revealed subclinical hypothyroidism, 5 (2.7%) revealed biochemical primary hypothyroidism, 7 (3.7%) revealed sick euthyroid syndrome, and 7 (3.7%) revealed hyperthyroidism. CONCLUSION: These results suggest that autoimmune thyroiditis is highly associated with RA in Korean patients, showing the increased prevalence of thyroid autoantibodies and thyroid dysfunctions.
Arthritis, Rheumatoid* ; Autoantibodies* ; Connective Tissue ; Euthyroid Sick Syndromes ; Female ; Hemagglutinins ; Humans ; Hyperthyroidism ; Hypothyroidism ; Luminescence ; Nephelometry and Turbidimetry ; Prevalence ; Rheumatoid Factor ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis, Autoimmune

The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prognosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively. The results were as follows : 1. Serum triiodothyronine(T3) reached to its nadir(30.05+/-17.5ng/dl, p<0.001) at 10 minutes after the start of CPB and remained low(p<0.05) throughout the study period. 2. Serum thyroxine(T4) concentration slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(fT4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37+/-0.81uIU/ml, p<0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum T3 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum T3 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.
Axis, Cervical Vertebra ; Euthyroid Sick Syndromes ; Heart* ; Hemodynamics ; Humans ; Myocardial Contraction ; Oxygen Consumption ; Prognosis ; Reference Values ; Thoracic Surgery* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones