Prevalence and Related Factors of Euthyroid Sick Syndrome in Children with Untreated Cancer According to Two Different Criteria

Duyu, A.; Çıtak, Elvan Çağlar; Ak, Erdem; Küpeli, Serhan; Küpeli, Begül Yağci; Bayram, İbrahim; Sezgin, Gülay; Eskendari, Gülçin; Sezer, Kerem

doi:10.4274/jcrpe.0015

Cited by 8 publications

(5 citation statements)

References 36 publications

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“…3). NTIS in children has been described in pediatric ICU (PICU) populations with varying diagnostic categories [44, 45], in patients undergoing cardiac surgery [46–49], in patients suffering from sepsis or septic shock [50–53], and in those with oncological diseases [54, 55]. The critical illness–induced rise in rT3 was found to be more pronounced in infants than in older children and resulted in a lower T3/rT3 ratio [44].…”

Section: Ntis In Critically Ill Infants and Children Treated In Thmentioning

confidence: 99%

Nonthyroidal Illness Syndrome Across the Ages

Langouche

Jacobs

Berghe

2019

Journal of the Endocrine Society

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In conditions of acute illness, patients present with reduced plasma T3 concentrations without a concomitant rise in TSH. In contrast, plasma concentrations of the inactive hormone rT3 increase, whereas plasma concentrations of T4 remain low-normal. This constellation of changes, referred to as nonthyroidal illness syndrome (NTIS), is present across all ages, from preterm neonates and over-term critically ill infants and children to critically ill adults. Although the severity of illness strongly correlates with the severity of the NTIS phenotype, the causality of this association remains debated, and pathophysiological mechanisms remain incompletely understood. In the acute phase of illness, NTIS appears to be caused predominantly by an increased peripheral inactivation of thyroid hormones, in which reduced nutritional intake plays a role. Current evidence suggests that these acute peripheral changes are part of a beneficial adaptation of the body to reduce expenditure of energy and to activate the innate immune response, which is important for survival. In contrast, in more severely ill and prolonged critically ill patients, an additional central suppression of the thyroid hormone axis alters and further aggravates the NTIS phenotype. Recent studies suggest that this central suppression may not be adaptive. Whether treatment of this central component of NTIS in prolonged critically ill patients, with the use of hypothalamic releasing factors, improves outcome remains to be investigated in large randomized control trials.

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Section: Ntis In Critically Ill Infants and Children Treated In Thmentioning

confidence: 99%

Nonthyroidal Illness Syndrome Across the Ages

Langouche

Jacobs

Berghe

2019

Journal of the Endocrine Society

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“…In laboratory investigations; hemoglobin level was 9.8 g/dl, leukocyte count was 14820/mm 3, platelet count was 363000/mm 3 Euthyroid sick syndrome is characterized by modifications of the thyroid hormones due to nonthyroidal diseases. Euthyroid sick syndrome was present if free triiodothyronine (fT3) was below the lower limit and free thyroxine was within the normal or low limits, thyroidstimulating hormone (TSH) was in the normal range (8). fT3 level of our patient was 3.55 ng/l (N:2.15-5.83).…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 72%

“…ESS has been described in liver disease, renal failure, after stress or surgery, in malnutrition or in malignancies. ESS is present if free fT3 was below the lower limit and free T4 was within the normal or low limits, while TSH was in the normal range ( 8 ). fT3 level of our patient was 3.55 ng/L (normal range: 2.15-5.83).…”

Section: Discussionmentioning

confidence: 99%

Novel MTTP Gene Mutation in a Case of Abetalipoproteinemia with Central Hypothyroidism

Ustkoyuncu¹,

Gökay²,

Eren³

et al. 2020

Jcrpe

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“…The diastolic and systolic blood pressures of the ESS group are significantly lower than those of the non-ESS group. A drop in blood pressure often indicates shock, insufficient tissue perfusion, etc., causing severe metabolic disorders and systemic inflammatory reactions ( 26 ). Often, a drop in blood pressure during shock indicates that the shock has entered a decompensated period.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Incidence of Euthyroid Sick Syndrome in Comprehensive Intensive Care Units and Related Risk Factors

et al. 2021

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ObjectiveA low concentration of plasma triiodothyronine (T3) indicates euthyroid sick syndrome (ESS), which could be associated with a poor outcome in patients in intensive care units (ICUs). This study evaluated the relationship between ESS and prognostic indicators in patients admitted to an ICU and examined the free T3 (FT3) cut-off points that could be associated with 28-day mortality.MethodsThis prospective observational study included patients admitted to the ICU of The Third Hospital of Hebei Medical University between February and November 2018. Baseline variables and data on the occurrence of low FT3 were collected. The patients were divided into ESS (FT3 < 3.28 pmol/L) and non-ESS groups. The relationship between ESS and prognostic indicators in patients admitted to the ICU was evaluated, and the FT3 cut-off points that could be associated with 28-day mortality were examined.ResultsOut of a total of 305 patients, 118 (38.7%) were in the ESS group. Levels of FT3 (P < 0.001) and FT4 (P = 0.001) were lower, while the 28-day mortality rate (P < 0.001) and hospitalization expenses in the ICU (P = 0.001) were higher in the ESS group. A univariable analysis identified ESS, FT3, free thyroxine (FT4)/FT3, the APACHE II score, the sequential organ failure (SOFA) score, the duration of mechanical ventilation, creatinine (CREA) levels, the oxygenation index (HGB), white blood cells, albumin (ALB) levels, age, and brain natriuretic peptide (BNP) levels as factors associated with 28-day mortality (all P < 0.05). The cut-off value of FT3 for 28-day mortality was 2.88 pmol/L, and the 28-day mortality rate and hospitalization expenses in the ICU were higher in patients with ESS. The syndrome was confirmed to be independently associated with 28-day mortality.ConclusionThis study determined the incidence of ESS in the comprehensive ICU to be 38.7%. APACHE II, SOFA, BNP, APTT, HGB, PLT, CREA, ALB, FT4, SBP, and DBP are closely related to ESS, while BNP, PLT, and ALB are independent risk factors for the syndrome.

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Prevalence and Related Factors of Euthyroid Sick Syndrome in Children with Untreated Cancer According to Two Different Criteria

Cited by 8 publications

References 36 publications

Nonthyroidal Illness Syndrome Across the Ages

Nonthyroidal Illness Syndrome Across the Ages

Novel MTTP Gene Mutation in a Case of Abetalipoproteinemia with Central Hypothyroidism

Analysis of the Incidence of Euthyroid Sick Syndrome in Comprehensive Intensive Care Units and Related Risk Factors

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