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Prospective study on thyroid function anomalies in severely ill patients.
Ann Ital Med Int. 1992 Jan-Mar; 7(1):13-8.AI

Abstract

Patients with severe non-thyroidal illness (NTI) often evidence concomitant anomalies in thyroid function (TF). In order to shed light on the implications of these anomalies and/or changes and disease course, we monitored TF changes in a selected cohort of 45 patients with serious NTI (21 with liver cirrhosis, 15 with renal failure and 9 with malignancy) from April 1985 to October 1989. TF test results on admission were as follows: all patients had normal thyroid stimulating hormone (TSH) levels; 16 patients had no TF abnormalities; 28 had decreased serum triiodothyronine (T3) and increased serum reverse triiodothyronine (rT3) levels, (8 of them had low serum free T3 values as well); 1 patient had subnormal level of both T3 and thyroxine (T4). Fifteen (53.5%) of the 28 subjects with initial low T3 sustained a subsequent decline in total and free serum T4 to subnormal levels; in 13 of these patients the drop occurred shortly before death. Patients in critical condition with below normal serum T4 also had decreased serum TSH concentrations: the so-called "low T3 and low T4 syndrome" might thus result from decreased TSH concentrations: due to failure of the usual feedback mechanism. Eighteen patients (40%) had died by the end of the study period. The mortality rate was 89% in patients with initial T3 level less than 0.40 nmol/L. This finding leads us to the hypothesis that initial low T3 levels in NTI patients are indicative of a poor prognosis.

Authors+Show Affiliations

Cattedra di Patologia Medica, Istituto di Medicina Interna e Geriatria, Università degli Studi di Palermo.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

1524944

Citation

Custro, N, et al. "Prospective Study On Thyroid Function Anomalies in Severely Ill Patients." Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna, vol. 7, no. 1, 1992, pp. 13-8.
Custro N, Scafidi V, Costanzo G, et al. Prospective study on thyroid function anomalies in severely ill patients. Ann Ital Med Int. 1992;7(1):13-8.
Custro, N., Scafidi, V., Costanzo, G., & Notarbartolo, A. (1992). Prospective study on thyroid function anomalies in severely ill patients. Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna, 7(1), 13-8.
Custro N, et al. Prospective Study On Thyroid Function Anomalies in Severely Ill Patients. Ann Ital Med Int. 1992 Jan-Mar;7(1):13-8. PubMed PMID: 1524944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective study on thyroid function anomalies in severely ill patients. AU - Custro,N, AU - Scafidi,V, AU - Costanzo,G, AU - Notarbartolo,A, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 13 EP - 8 JF - Annali italiani di medicina interna : organo ufficiale della Societa italiana di medicina interna JO - Ann. Ital. Med. Int. VL - 7 IS - 1 N2 - Patients with severe non-thyroidal illness (NTI) often evidence concomitant anomalies in thyroid function (TF). In order to shed light on the implications of these anomalies and/or changes and disease course, we monitored TF changes in a selected cohort of 45 patients with serious NTI (21 with liver cirrhosis, 15 with renal failure and 9 with malignancy) from April 1985 to October 1989. TF test results on admission were as follows: all patients had normal thyroid stimulating hormone (TSH) levels; 16 patients had no TF abnormalities; 28 had decreased serum triiodothyronine (T3) and increased serum reverse triiodothyronine (rT3) levels, (8 of them had low serum free T3 values as well); 1 patient had subnormal level of both T3 and thyroxine (T4). Fifteen (53.5%) of the 28 subjects with initial low T3 sustained a subsequent decline in total and free serum T4 to subnormal levels; in 13 of these patients the drop occurred shortly before death. Patients in critical condition with below normal serum T4 also had decreased serum TSH concentrations: the so-called "low T3 and low T4 syndrome" might thus result from decreased TSH concentrations: due to failure of the usual feedback mechanism. Eighteen patients (40%) had died by the end of the study period. The mortality rate was 89% in patients with initial T3 level less than 0.40 nmol/L. This finding leads us to the hypothesis that initial low T3 levels in NTI patients are indicative of a poor prognosis. SN - 0393-9340 UR - https://www.unboundmedicine.com/medline/citation/1524944/Prospective_study_on_thyroid_function_anomalies_in_severely_ill_patients_ DB - PRIME DP - Unbound Medicine ER -