Hypocortisolism in survivors of severe acute respiratory syndrome (SARS)

Leow, Melvin Khee–Shing; Kwek, Daniel Seow Khee; Ng, Alan; Ong, K. C. G.; Kaw, Gregory; Lee, Lawrence S.

doi:10.1111/j.1365-2265.2005.02325.x

Cited by 259 publications

(309 citation statements)

References 34 publications

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“…Therefore, the hypothalamuspituitary dysfunction may be the underlying cause of low serum TSH. Leow et al [10] reported that 4 of 61 SARS survivors (6.7%) were hypothyroid including 3 cases with central hypothyroidism and 1 with primary hypothyroidism with positive autoimmune antibodies. In addition to hypothyroidism, they reported a more frequent occurrence of central hypocortisolism in a substantial number of patients with SARS.…”

Section: Discussionmentioning

confidence: 99%

“…A substantial number of patients with SARS have shown abnormalities in either of these 2 functions, which lends support to the supposition that SARS has a harmful effect on the thyroid gland. In some cases, decreased T3 and T4 serum levels were detected suggesting follicular cell dysfunction [9,10]. In other cases, osteonecrosis of the femoral head was found in recovered patients with SARS, which may have been caused by a decrease of inhibition of osteoclasts resulting from calcitonin deficiency [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Pathology of the thyroid in severe acute respiratory syndrome

et al. 2007

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The severe acute respiratory syndrome (SARS) epidemic started in November 2002 and spread worldwide. The pathological changes in several human organs of patients with SARS have been extensively described. However, to date, little has been reported about the effects of this infection on the thyroid gland. Femoral head necrosis and low serum triiodothyronine and thyroxine levels, commonly found in patients with SARS, raise the possibility of thyroid dysfunction. We have undertaken this study to evaluate for any potential injury to the thyroid gland caused by SARS on tissue samples obtained from 5 SARS autopsies. The terminal deoxynucleotidyl transferase-mediated dUPT nick end-labeling assay was performed to identify apoptotic cells. The follicular epithelium was found to be damaged with large numbers of cells exfoliated into the follicle. The terminal deoxynucleotidyl transferase-mediated dUPT nick end-labeling assay demonstrated many cells undergoing apoptosis. Follicular architecture was altered and showed distortion, dilatation, and collapse. No distinct calcitonin-positive cells were detectable in the SARS thyroids. In conclusion, both parafollicular and follicular cells were injured. This may provide an explanation both for low serum triiodothyronine and thyroxine levels and the osteonecrosis of the femoral head associated with patients with SARS. Apoptosis may play a role in the pathogenesis of SARS associated coronavirus infection in the thyroid gland.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathology of the thyroid in severe acute respiratory syndrome

et al. 2007

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“…During the SARS outbreak in 2003, four healthcare workers from one hospital contracted the disease and were treated with corticosteroids that resulted in the development of ONFH [11,12]. All patients were treated with cocktail therapy that consists of ESWT, hyperbaric oxygen therapy (HBO) (2.5 ATA in 15 min) and oral alendronate (70 mg of oral alendronate sodium) [12].…”

Section: Eswt and Cocktail Therapy For Onfhmentioning

confidence: 99%

Extracorporeal shockwave therapy for avascular necrosis of femoral head

Wang

Cheng

Huang

et al. 2015

International Journal of Surgery

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The etiology of osteonecrosis of the femoral head (ONFH) is multifactorial. Treatment of ONFH is disease stage dependent. For early stages, femoral head preservation procedures are preferred including core decompression, muscle pedicle grafting and de-rotational osteotomy. Core decompression with bone grafting is considered the gold standard. However, the results are inconsistence and unpredictable. An effective non-invasive method of treatment is imperative. Recently, extracorporeal shockwave therapy (ESWT) has shown beneficial effects in ONFH. ESWT improves pain and function of the hip and regression of the ONFH lesion. ESWT is more effective than core decompression with or without bone grafting, cocktail therapy that combined HBO, ESWT and oral alendronate is shown effective for patients with early osteonecrosis. The purpose of the article is to review, update and summarize the clinical treatment of ONFH using shockwave therapy.

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“…Severe acute respiratory syndrome (SARS) was one of the most challenging public‐health crises faced in Hong Kong in 2003, infecting 1755 people and claiming 299 lives . Many SARS survivors are still suffering physical, functional, and psychological and behavioural disorders after the acute infection, which requires long‐term medical attention and reached a chronic phase.…”

Section: Introductionmentioning

confidence: 99%

Coping with future epidemics: Tai chi practice as an overcoming strategy used by survivors of severe acute respiratory syndrome (SARS) in post‐SARS Hong Kong

Siu

2014

Health Expectations

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Background Although SARS had been with a controversial topic for a decade at the time of this study, numerous SARS survivors had not yet physically, psychologically or socially recovered from the aftermath of SARS. Among chronically ill patients, the use of complementary and alternative medicine (CAM) is reported to be widespread. However, extremely little is known about the use of CAM by SARS survivors in the post-SARS period and even less is known about how the use of CAM is related to the unpleasant social and medical-treatment experiences of SARS survivors, their eagerness to re-establish social networks, and their awareness to prepare for future epidemics.

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Hypocortisolism in survivors of severe acute respiratory syndrome (SARS)

Abstract: These preliminary findings highlight a possible aetiologic role of SARS-associated coronavirus in causing a reversible hypophysitis or direct hypothalamic effect, with the HPA axis affected more frequently than the HPT axis.

Cited by 259 publications

References 34 publications

Pathology of the thyroid in severe acute respiratory syndrome

Pathology of the thyroid in severe acute respiratory syndrome

Extracorporeal shockwave therapy for avascular necrosis of femoral head

Coping with future epidemics: Tai chi practice as an overcoming strategy used by survivors of severe acute respiratory syndrome (SARS) in post‐SARS Hong Kong

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