Euthyroid sick syndrome natural history, complications and prognosis

Jump to navigation Jump to search

Euthyroid sick syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Euthyroid sick syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography/Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Euthyroid sick syndrome natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Euthyroid sick syndrome natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Euthyroid sick syndrome natural history, complications and prognosis

CDC on Euthyroid sick syndrome natural history, complications and prognosis

Euthyroid sick syndrome natural history, complications and prognosis in the news

Blogs on Euthyroid sick syndrome natural history, complications and prognosis

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Euthyroid sick syndrome natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

If left untreated, patients with euthyroid sick syndrome may progress to develop hypothyroidism or resolve spontaneously with correction of underlying condition. If underlying condition is not corrected, the thyroid hormone levels starts to drop after 2-3 weeks of initial illness. The symptoms of hypothyroidism may take some additional weeks before they start to appear. The complications of euthyroid sick syndrome depends upon other organ systems involved and underlying disease. The general complications of hypothyroidism as seen in euthyroid sick syndrome include hypothermia, bradycardia, heart failure, dyspnea, myopathy, confusion, apathy and psychosis. Laboratory findings will show increased levels of cholesterol and triglycerides. In addition, patients will have features of organs system involvement. The prognosis varies and depends upon extent of the underlying disease at the time of diagnosis. Patients with low T3 (< 2.3 pg/ml) levels may have a longer hospital stay. Mortality rate is as high as 80% when serum T4 value is <3 mcg/dL.

Natural History, Complications, and Prognosis

Natural History

If left untreated, patients with euthyroid sick syndrome may either progress to develop hypothyroidism or resolve spontaneously with correction of underlying condition.[1]

Complications

The complications of euthyroid sick syndrome depends upon other organ systems involved and underlying disease. The general complications of hypothyroidism as seen in euthyroid sick syndrome include:

Laboratory finding will show increased levels of cholesterol and triglycerides. In addition, patients will have complications of the particular organs system involved.[2][3]

Prognosis

Depending on the extent of the underlying disease at the time of diagnosis, the prognosis may vary. Patients with low free T3 (< 2.3 pg/ml) levels may have a longer hospital stay and higher rates of intensive care unit admission. Mortality rate is as high as 80% when serum T3 is extremely low and/or T4 value is <3 mcg/dL.[4][5][6][7][8]

References

  1. Fliers, Eric; Bianco, Antonio C; Langouche, Lies; Boelen, Anita (2015). "Thyroid function in critically ill patients". The Lancet Diabetes & Endocrinology. 3 (10): 816–825. doi:10.1016/S2213-8587(15)00225-9. ISSN 2213-8587.
  2. Docter R, Krenning EP, de Jong M, Hennemann G (1993). "The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism". Clin. Endocrinol. (Oxf). 39 (5): 499–518. PMID 8252737.
  3. Shanoudy H, Soliman A, Moe S, Hadian D, Veldhuis JD, Iranmanesh A, Russell DC (2001). "Early manifestations of "sick euthyroid" syndrome in patients with compensated chronic heart failure". J. Card. Fail. 7 (2): 146–52. doi:10.1054/jcaf.2001.24665. PMID 11420766.
  4. Liu J, Wu X, Lu F, Zhao L, Shi L, Xu F (2016). "Low T3 syndrome is a strong predictor of poor outcomes in patients with community-acquired pneumonia". Sci Rep. 6: 22271. doi:10.1038/srep22271. PMC 4772089. PMID 26928863.
  5. Slag MF, Morley JE, Elson MK, Crowson TW, Nuttall FQ, Shafer RB (1981). "Hypothyroxinemia in critically ill patients as a predictor of high mortality". JAMA. 245 (1): 43–5. PMID 7431627.
  6. Özcan KS, Osmonov D, Toprak E, Güngör B, Tatlısu A, Ekmekçi A, Kaya A, Tayyareci G, Erdinler İ (2014). "Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention". Cardiol J. 21 (3): 238–44. doi:10.5603/CJ.a2013.0108. PMID 23990180.
  7. Muñoz-Ramirez Mdel R, Ortega-Valdez CA, Murillo-Heredia E (2016). "[Euthyroid sick syndrome as a risk factor for mortality in critically ill patients]". Med Clin (Barc) (in Spanish; Castilian). 146 (9): 414–5. doi:10.1016/j.medcli.2015.09.002. PMID 26520613.
  8. Rothberger GD, Gadhvi S, Michelakis N, Kumar A, Calixte R, Shapiro LE (2017). "Usefulness of Serum Triiodothyronine (T3) to Predict Outcomes in Patients Hospitalized With Acute Heart Failure". Am. J. Cardiol. 119 (4): 599–603. doi:10.1016/j.amjcard.2016.10.045. PMID 28017303.

Template:WH Template:WS