Abnormalities of Thyroid Hormone Metabolism during Systemic Illness: The Low T3 Syndrome in Different Clinical Settings

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...

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Published inInternational Journal of Endocrinology Vol. 2016; no. 2016; pp. 231 - 239-025
Main Authors Moura Neto, Arnaldo, Zantut-Wittmann, Denise E.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Limiteds 01.01.2016
Hindawi Publishing Corporation
John Wiley & Sons, Inc
Hindawi Limited
Subjects
Ambulatory care
Chronic illnesses
Cytokines
Development and progression
Diabetes
Endocrinology
Genetic aspects
Heart failure
HIV
Human immunodeficiency virus
Intensive care
Liver diseases
Metabolism
Musculoskeletal system
Pathophysiology
Physiological aspects
Prognosis
Review
Systemic diseases
Thyroid diseases
Thyroid gland
Thyroid hormones
Brazil
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Summary: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.
Bibliography:ObjectType-Article-2
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Academic Editor: Giuseppe Damante
ISSN:1687-8337
1687-8345
DOI:10.1155/2016/2157583