-It is well known that the central nervous system (CNS) influences the pituitary hormone secretions and that diseases of CNS are frequently associated with an altered endocrine function. The aim of this study has been the evaluation of the serum concentrations of the pituitary and thyroid hormones in a series of patients with subarachnoid hemorrhage due to a ruptured cerebral aneurysm. Thirty-five patients (23 females and 12 males), aged 51.9±13.3 years on the mean were admitted. They were evaluated to assess the clinical severity of the subarachnoid hemorrhage by Hunt & Hess scale: nine patients were in the grade I, 14 in the grade II, and 12 in the grade III. Blood samples were obtained between 8:00 and 9:00 a.m. and serum hormones were measured by commercial kits (IRMA or MEIA methods). Cortisol serum levels (normal range (NR) = 5 to 18 µg/dL) were increased in all the patients (mean ± standard deviation = 31.4±12.4 µg/dL). Mean prolactin levels (NR < 20 ng/mL) were 18.6±17.1 ng/mL and five patients (14.2%) had levels higher than normal. FSH and LH levels were normal according to age and sex: men: FSH = 4±2.9 mUI/mL (NR = 1 to 10.5 mUI/mL); LH = 6.1±6.3 mUI/mL (NR = 2 to 12 mUI/mL); premenopausa women: FSH = 2.5±1.5 mUI/mL (NR = 2.4 to 9.3 mUI/mL); LH 3.9±5.1 mUI/mL (NR =2 to 15 mUI/mL); post-menopausal women: FSH = 48.3±18.5 mUI/mL (NR =31 to 134 mUI/mL); LH = 29±13.8 mUI/mL (NR =16 to 64 mUI/mL). Mean TSH levels were 3.9±5.2 µUI/mL (NR =0.5 to 4.7 µUI/mL) and five patients (14.2%) had levels higher than normal. Mean triiodothyronine levels (T3) were 66.4±18.7 ng/dL (NR = 45 to 137 ng/dL) and five patients (14.2%) had levels lower than normal (33.8±9 ng/dL). Mean thyroxine levels (T4) (NR= 4.5 to 12.5 µg/dL) were 7.4±1.7 µg/dL and two patients (5.6%) had levels lower than normal. Thyroglobulin and microsomal antibodies were not detectable. Conclusions: In the first 24 hours following ictus, the hormonal changes may be due to the stress produced by the intracranial bleeding; thyroid hormone alterations suggest that patients with subarachnoid hemorrhage might have an euthyroid sick syndrome.KEY WORDS: cerebral aneurysm, subarachnoid hemorrhage, pituitary, thyroid hormones, euthyroid sick syndrome.Avaliação dos hormônios hipofisários e tireoidianos em pacientes com hemorragia subaracnoidea devido Avaliação dos hormônios hipofisários e tireoidianos em pacientes com hemorragia subaracnoidea devido Avaliação dos hormônios hipofisários e tireoidianos em pacientes com hemorragia subaracnoidea devido Avaliação dos hormônios hipofisários e tireoidianos em pacientes com hemorragia subaracnoidea devido Avaliação dos hormônios hipofisários e tireoidianos em pacientes com hemorragia subaracnoidea devido a ruptura de aneurisma intracraniano a ruptura de aneurisma intracraniano a ruptura de aneurisma intracraniano a ruptura de aneurisma intracraniano a ruptura de aneurisma intracraniano RESUMO -É bem conhecido que o sistema nervoso central (SNC) influencia as secreções dos hormônios hipofisários e que doenças do SN...
-We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH) is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS). In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A) 30 patients with SH (21 females and 9 males; 41.7±11.4 years) and B) a control group including 25 patients with benign diseases of the spine (BDS) (lumbar disc hernia or stable spinal trauma) (8 females and 17 males; 41.3±14.2 years). In a subgroup of eight patients of each group serum triiodothyronine (T3) and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (p<0.05): T3 (ng/mL): SH = 58.7±1.1 and BDS = 74.5±13.9; free T4 (ng/dL): SH = 0.9±0.2 and BDS = 1.1±0.3. There was no significant difference in the serum levels of total thyroxine (T4) and thyroid-stimulating hormone (TSH) between the two groups: T4 (µg/dL): SH = 6.9±1.1 and BDS = 7.4±2.1; TSH (µUI/mL): SH = 1.5±0.8 and BDS = 1.8±1,0. In the sample of eight patients of each group we had the following results: T3 (ng/mL): SH = 66.8±3.8 and BDS = 77.2±1.1 (p <0.05); reverse T3 (ng/dL): SH = 32.8±8 and BDS = 24.7±2.2 (NS); T3/ reverse T3 ratio: SH = 2.6±0.3 and BDS = 3.3±0.4 (NS). Thyreoglobulin and microsomal antibodies were not detectable, except in one patient in the SH group. In conclusion, the SH patients present serum levels of T3 and free T4 significantly lower than that of BDS patients; the thyroidal hormone profile suggests that SH patients have developed the nonthyroidal illness syndrome.KEY WORDS: cerebral aneurysm, euthyroid sick syndrome, nonthyroidal illness syndrome, subarachnoid hemorrhage, thyroid hormones. Sindrome da doença não tiroideana em pacientes com hemorragia subaracnoidea devida a aneurisma cerebralRESUMO -Nós apresentamos previamente que a hemorragia subaracnoidea devido à ruptura de aneurisma intracraniano (SH) está associada com alterações no perfil hormonal nas primeiras 24 horas após o evento. Nós propusemos que as alterações hormonais observadas são devidas ao intenso estresse ao qual os pacientes estão expostos. Contudo, o perfil hormonal tireoidiano é indicativo da presença da síndrome da doença não tireoidiana (NTIS). Neste trabalho, examinamos se as alterações no perfil dos hormônios tireoidianos são compatíveis com a NTIS. Dois grupos de pacientes foram incluídos no estudo: A) 30 pacientes com SH (21 mulheres e 9 homens; 41,7±11,4 anos) e B) um grupo controle incluindo 25 pacientes com doenças benignas da coluna (BDS) (hérnia de disco lombar ou estável trauma da coluna) (8 mulheres e 17 homens; 41,3±14...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.