Euthyroid sick syndrome, associated endocrine abnormalities, and outcome in elderly patients undergoing emergency operation

Girvent, Meritxell; Maestro, Sylvia; Hernández, R Sánchez; Carajol, Isabel; Monné, J; Sancho, José Luis Valero; Gubern, J M; Sitges‐Serra, Antonio

doi:10.1067/msy.1998.87238

Cited by 60 publications

(35 citation statements)

References 20 publications

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“…Prognosis of patients with this syndrome is correlated with serum levels of T3 and T4. [21][22][23][24] In our study, low T3, T4 levels among groups with higher mortality and complication rates were found.…”

mentioning

confidence: 67%

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The prognostic value of Pro-Calcitonin, CRP and thyroid hormones in secondary peritonitis;A single-center prospective study

Akcay¹,

Okoh²,

Yalav³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Infections and sepsis remain the leading cause of morbidity and mortality in secondary peritonitis. Clinicians are still challenged with the task of finding an early and reliable diagnosis of septic complications. The role of inflammatory markers (Procalcitonin (PCT), C-reactive Protein (CRP) and thyroid hormones in determining the severity of secondary peritonitis was evaluated in this study.

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mentioning

confidence: 67%

“…[24] In most studies, low serum T3 and T4 has been associated with a higher mortality in sepsis and severe bacterial infections. While the reported mortality ratio in patients with T4 levels lower than 3 µg/dl is between 64% and 84%, patients with the same disease but normal thyroid levels were found to have mortality below 22%.…”

mentioning

confidence: 99%

The prognostic value of Pro-Calcitonin, CRP and thyroid hormones in secondary peritonitis;A single-center prospective study

Akcay¹,

Okoh²,

Yalav³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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“…Tiroid fonksiyon bozukluğunun temeldeki hastalığın ciddiyetiyle ilişki göster-diği ve düşük tiroid hormon seviyelerinin birçok hastalıkta kötü prognozla ilişkili olduğu bilinmektedir. (6,7,8) Çalışmamızda akut koroner sendrom tanılı hastalarda ötiroid hasta sendromunun sıklığı ve özellikleri araştı-rılmıştır.…”

Section: Introductionunclassified

Evaluation Of The Incidence Of Euthyroid Sick Syndrome In Acute coronary Syndrome

Üstündağ¹,

Can²,

Emen³

et al. 2011

Tepecik Dergisi

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Adife ÇETİNTÜRK ÜSTÜNDAĞHüseyin CAN Bahar EMEN Mert ÖZBAKKALOĞLU ÖZET Amaç: Birçok hastalık seyrinde ve akut stres durumlarında ortaya çıkan ötiroid hasta sendromunun, hastanemize başvuran ve akut koroner sendrom (AKS) tanısıyla koroner yoğun bakım ünitesinde izlenen hastalardaki sıklığını ve özelliklerini araştırmaktı. Bulgular: Çalışma sonunda diğer sistemik hastalıklarda görülme oranı yaklaşık %40 olan ötiroid hasta sendromu sıklığı AKS tanılı hastalarda %41.4 oranında bulundu. Kararsız angina pektoris tanılı hastaların %25.7'inde, ST yükselmesi akut miyokard infarktüsü tanılı hastaların %11.4'ünde ve ST yükselmesi olmayan akut miyokard infarktüsü tanılı hastaların %4.3'ünde ötiroid hasta sendromu saptandı. Ötiroid hasta sendromunun baskın formu olan düşük T3 sendromu %27.1 oranında tespit edildi. Düşük T3,T4 sendromu %7.1 oranında, yüksek T4 sendromu %4.3 oranında ve düşük TSH,T3,T4 sendromu %2.9 oranında bulundu. Sonuç: Akut koroner sendrom tanılı hastaların tiroid hormon düzeyleri metabolik olarak bulgu vermemekle beraber düşmekte ve sık olarak sınır düzeylerinin altına inebilmektedir. Bu durum ötiroid hasta sendromu olarak tanımlanmakta ve başka hastalıkların seyri esnasında da sıkça rastlanmaktadır. Geçici bir klinik antite olmakla beraber akut miyokard infarktüsünde sınır düzeylerinin altına inmiş serbest T3 (ST3) düzeyleri kötü prognozla ilişkilendirilmiştir. Bu nedenle ötiroid hasta sendromu'nun değişik tipleri tanınmalı ve klinisyenin dikkatini çekmelidir. Gereç veAnahtar Sözcükler: Anjina pektoris, koroner iskemi, miyokard imfarktüsü, troid hastalığı.

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“…SES is characterized by decreased total T 3 levels and reciprocally increased reverse T 3 levels (20). For pathophysiology of SES, impaired peripheral deiodination of tetraiodothyronine (T 4 ), decreased TRH metabolism and reduced TH receptor expression have been suggested (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

The relationship of thyroid hormone status with myocardial function in stress cardiomyopathy

Lee

Kang

Ryu

et al. 2009

European Journal of Endocrinology

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Objective: This study aimed to investigate thyroid hormone (TH) status and its relationship with myocardial function as well as clinical and biochemical parameters in stress cardiomyopathy (CMP). Methods: Forty-five patients with stress CMP (the patient group), 31 patients without stress CMP (the control II group), and 58 healthy subjects (the control I group) were included. Sick euthyroid syndrome (SES) was defined as low total triiodothyronine (T 3 ) with normal TSH levels. Results: In the patient group at admission, prevalence of SES was 62.2%. Compared with the control I group, the patient group had a decrease in left ventricular ejection fraction (LVEF) and systolic blood pressure (BP) and an increase in troponin-I, CK-MB, and B-type natriuretic peptide (BNP) levels. Total T 3 levels were reduced, and anti-thyroid peroxidase antibody (anti-TPO Ab) positivity, C-reactive protein (CRP) and cortisol levels were elevated. Total T 3 levels were associated with acute physiology and chronic health evaluation II (APACHE II) score, LVEF, systolic BP, and cortisol levels in multivariate analysis. In the control II group, total T 3 levels were not associated with any variables. In the SES (nZ28) and myocardial dysfunction (MDys, nZ27) subgroups, increased APACHE II score and BNP levels as well as decreased LVEF and systolic BP were significant. Total T 3 levels were reduced, and CRP, cortisol and catecholamines levels were elevated. In the MDys subgroup, anti-TPO Ab positivity and titer were increased. Conclusion: These results suggest that total T 3 levels may be associated with myocardial contractility, clinical severity, and cortisol levels. Thyroid autoimmunity may influence myocardial contractility in stress CMP.

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Euthyroid sick syndrome, associated endocrine abnormalities, and outcome in elderly patients undergoing emergency operation

Cited by 60 publications

References 20 publications

The prognostic value of Pro-Calcitonin, CRP and thyroid hormones in secondary peritonitis;A single-center prospective study

The prognostic value of Pro-Calcitonin, CRP and thyroid hormones in secondary peritonitis;A single-center prospective study

Evaluation Of The Incidence Of Euthyroid Sick Syndrome In Acute coronary Syndrome

The relationship of thyroid hormone status with myocardial function in stress cardiomyopathy

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