Thyroid abnormalities in term infants with fungal sepsis

Silva, Maria Helena Baptista Nunes da; Araújo, Maria Christina Barbosa de; Diniz, Edna Maria de Albuquerque; Ceccon, Maria Esther Jurfest Rivero; Carvalho, Werther Brunow de

doi:10.1590/1806-9282.62.06.561

Cited by 6 publications

(8 citation statements)

References 36 publications

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“…Characteristic patterns of NTIS have been described in a multitude of acute and chronic somatic illnesses including states of shock (284), circulatory arrest (285, 286), respiratory failure (65), community-acquired pneumonia (287), sepsis (288), chronic respiratory (289, 290) and cardiovascular (61, 64, 66, 291, 292) disease, renal failure (293–298), COPD (289), gastrointestinal diseases (299–301), autoimmune diseases (71, 302, 303), and cancer (130, 290, 304). Phenotypes of NTIS with high and high-normal FT4 concentrations have been described in dementia and frailty in elderly persons (305).…”

Section: Thyroid Allostasis In Various Physiological and Pathologicalmentioning

confidence: 99%

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Hoermann²,

et al. 2017

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The hypothalamus–pituitary–thyroid feedback control is a dynamic, adaptive system. In situations of illness and deprivation of energy representing type 1 allostasis, the stress response operates to alter both its set point and peripheral transfer parameters. In contrast, type 2 allostatic load, typically effective in psychosocial stress, pregnancy, metabolic syndrome, and adaptation to cold, produces a nearly opposite phenotype of predictive plasticity. The non-thyroidal illness syndrome (NTIS) or thyroid allostasis in critical illness, tumors, uremia, and starvation (TACITUS), commonly observed in hospitalized patients, displays a historically well-studied pattern of allostatic thyroid response. This is characterized by decreased total and free thyroid hormone concentrations and varying levels of thyroid-stimulating hormone (TSH) ranging from decreased (in severe cases) to normal or even elevated (mainly in the recovery phase) TSH concentrations. An acute versus chronic stage (wasting syndrome) of TACITUS can be discerned. The two types differ in molecular mechanisms and prognosis. The acute adaptation of thyroid hormone metabolism to critical illness may prove beneficial to the organism, whereas the far more complex molecular alterations associated with chronic illness frequently lead to allostatic overload. The latter is associated with poor outcome, independently of the underlying disease. Adaptive responses of thyroid homeostasis extend to alterations in thyroid hormone concentrations during fetal life, periods of weight gain or loss, thermoregulation, physical exercise, and psychiatric diseases. The various forms of thyroid allostasis pose serious problems in differential diagnosis of thyroid disease. This review article provides an overview of physiological mechanisms as well as major diagnostic and therapeutic implications of thyroid allostasis under a variety of developmental and straining conditions.

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Section: Thyroid Allostasis In Various Physiological and Pathologicalmentioning

confidence: 99%

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Hoermann²,

et al. 2017

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“…This activity may be attributed to the complex pathophysiological interplay between thyroidstimulating hormone (TSH) and the immune system [3,4]. The various lymphokines and monokines factors act as a marker in sepsis and can influence the hypothalamic-pituitary-thyroid axis modulating thyroid hormone levels [3,5].Multiple studies have been performed in the recent past showing correlation of sepsis and thyroid hormones [6][7][8][9][10][11][12]. A study conducted by Kurt et al showed a significant change in thyroid hormone levels before and after the treatment of neonatal sepsis with antibiotics [6].…”

mentioning

confidence: 99%

Assessment of thyroid hormones in full-term neonates with late-onset sepsis

Singh¹,

Agrawal²,

Shrivastava³

2021

Indian J Child Health

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Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without bacteremia in neonatal age. The incidence of neonatal sepsis in India is 38 per 1000 live births according to the data obtained from the National Neonatal Perinatal Database [1]. It is classified into two types depending on the time of onset of symptoms: Early onset of sepsis (EOS) which presents within the first 72 h of life and late onset of sepsis (LOS) that occurs after 72 h of life [2].Many neuroendocrine changes take place during critical illness; however, reports of these changes in neonatal sepsis are limited. Thyroid hormones play an important role in the adaptation of metabolic function to stress, regulation of the metabolic homeostasis, and critical illness. Although the exact cause of alteration of thyroid hormones during sepsis is not known, it has been hypothesized that the immune system cells can affect systemic thyroid hormone activity. This activity may be attributed to the complex pathophysiological interplay between thyroidstimulating hormone (TSH) and the immune system [3,4]. The various lymphokines and monokines factors act as a marker in sepsis and can influence the hypothalamic-pituitary-thyroid axis modulating thyroid hormone levels [3,5].Multiple studies have been performed in the recent past showing correlation of sepsis and thyroid hormones [6][7][8][9][10][11][12]. A study conducted by Kurt et al. showed a significant change in thyroid hormone levels before and after the treatment of neonatal sepsis with antibiotics [6]. Joosten et al. performed a study on children with meningococcal sepsis found that the children who do not survive meningococcal sepsis have an impaired adrenal response, altered thyroid hormones, and below normal reference values of T4, T3, rT3, and TSH levels [7].The majority of the previous studies present in the literature have correlated LOS with T3, T4 hormone levels, or assay only, but in our study, we have included TSH, T3, and T4 along with fT3, and fT4 which are highly sensitive in the detection of thyroid hormone levels. Hence, the present study was conducted to find the relationship between thyroid profile and development of neonatal LOS in full-term neonates. MATERIALS AND METHODSThis analytical prospective study was carried out in the neonatal intensive care unit of the Department of Pediatric ABSTRACT Background: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without bacteremia in neonatal age. The previous studies found that there might be an association between thyroid hormone profile and outcomes in patients with late-onset of sepsis (LOS). Objective: The objective of the study was to assess the thyroid hormone levels in full-term neonates with late-onset sepsis. Materials and Methods: This analytical prospective cohort study was conducted in the neonatal intensive care unit of a tertiary care teaching institution in Central India. Full-term neonates, with culture-proven LOS, were taken as the study po...

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“…These findings also suggest that thyroid hormone levels improve when antenatal corticosteroids are used [14]. Corticosteroids not only stimulate lung maturity but also induce euthyroidism that ultimately improves the survival of neonates [12].…”

Section: Discussionmentioning

confidence: 85%

“…Studies [11] have also suggested a reduced action of T4 in peripheral tissues, through the demonstration of low serum levels of the angiotensin-converting enzyme, which is stimulated by thyroid hormones. In the recovery phase, there may be a temporary increase in TSH [12].…”

Section: Introductionmentioning

confidence: 99%

Non-thyroid Disease Syndrome and Other Thyroid Function Anomalies in Ecuadorian Newborns with Early and Late Neonatal Sepsis

Chimbo

Castro

González-Andrade

2019

SN Compr. Clin. Med.

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The aim of this study is to assess thyroid function in newborns with early and late neonatal sepsis by measuring T3, T4, and TSH. This study included 80 newborns with a diagnosis of neonatal sepsis divided into two groups: early neonatal sepsis and late neonatal sepsis, which during the clinical and laboratory manifestations of sepsis showed changes in thyroid hormones, particularly low T3 syndrome and low T3-T4. It excluded newborn children of mothers with thyroid disease and those with a history of perinatal asphyxia, congenital defects, and previous major surgeries. Development of the non-thyroid disease syndrome was confirmed in both study groups, with a prevalence of 54.2% for neonates with early neonatal sepsis and 80.95% for neonates with late neonatal sepsis. It also found low T3 in neonates with early neonatal sepsis and low T4 syndrome in neonates with late sepsis. Low levels of thyroid hormones are associated with a worse prognosis and a poor evolution in severely ill neonates. In Ecuadorian preterm infants with a mean gestational age of 32 weeks, the non-thyroid disease syndrome was found in 54.24% of the patients with early neonatal sepsis and in 80.95% with late neonatal sepsis. TSH levels are decreased in 11.86% of neonates with early neonatal sepsis and 10% in patients with late neonatal sepsis. All cases were children born of adolescent mothers with or without ruptured membranes, from urban areas of Quito.

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Thyroid abnormalities in term infants with fungal sepsis

Cited by 6 publications

References 36 publications

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Assessment of thyroid hormones in full-term neonates with late-onset sepsis

Non-thyroid Disease Syndrome and Other Thyroid Function Anomalies in Ecuadorian Newborns with Early and Late Neonatal Sepsis

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