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2016 ; 2016
(ä): 2157583
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Abnormalities of Thyroid Hormone Metabolism during Systemic Illness: The Low T3
Syndrome in Different Clinical Settings
#MMPMID27803712
Moura Neto A
; Zantut-Wittmann DE
Int J Endocrinol
2016[]; 2016
(ä): 2157583
PMID27803712
show ga
Thyroid hormone abnormalities are common in critically ill patients. For over
three decades, a mild form of these abnormalities has been described in patients
with several diseases under outpatient care. These alterations in thyroid hormone
economy are a part of the nonthyroidal illness and keep an important relationship
with prognosis in most cases. The main feature of this syndrome is a fall in free
triiodothyronine (T3) levels with normal thyrotropin (TSH). Free thyroxin (T4)
and reverse T3 levels vary according to the underlying disease. The importance of
recognizing this condition in such patients is evident to physicians practicing
in a variety of specialties, especially general medicine, to avoid misdiagnosing
the much more common primary thyroid dysfunctions and indicating treatments that
are often not beneficial. This review focuses on the most common chronic diseases
already known to present with alterations in serum thyroid hormone levels. A
short review of the common pathophysiology of the nonthyroidal illness is
followed by the clinical and laboratorial presentation in each condition.
Finally, a clinical case vignette and a brief summary on the evidence about
treatment of the nonthyroidal illness and on the future research topics to be
addressed are presented.