What is non thyroid sick syndrome?
summary
In the case of starvation or systemic disease, the concentration of thyroid hormone in the body often drops to the level of hypothyroidism. Previously, it has been considered that this is a compensatory reflection of the body, and the thyroid function is normal, so it is called normal thyroid sick syndrome. However, in the case of severe disease, the seriously reduced concentration of thyroid hormone (T4) increases with the mortality, Therefore, some people think that it is not well compensated, so now they tend to use the word without subjective color: non thyroid disease syndrome. What are the specific symptoms of non thyroid sick syndrome?
What is non thyroid sick syndrome?
Thyroid function normal lesion syndrome is the body to acute stress, chronic severe disease serum T3 or T4 level is low, RT3 level is increased, most patients with TSH is normal, this is the adaptive change of the body, general NTIS no obvious clinical symptoms, mainly the clinical manifestations of primary disease and thyroid function examination index changes.
Infectious diseases may have fever, increased white blood cell count, systemic poisoning symptoms; Nephrotic syndrome may have facial edema, massive proteinuria, hypoproteinemia, etc; Chronic renal failure patients may have facial edema, hypertension, anemia, bun and serum creatinine elevation; The patients with liver diseases had yellow skin and mucous membrane, spider nevus, liver palms, varicose veins, hepatosplenomegaly and abnormal liver function; Diabetic patients may have polydipsia, polyuria, overeating, emaciation, fatigue, and elevated blood glucose and glycosylated hemoglobin; Patients with myocardial infarction may have a history of coronary heart disease, changes in myocardial enzymes and ECG; Other heart and lung diseases have their own clinical manifestations and signs; Patients with malignant tumor may have local and metastatic symptoms, tumor markers increased, imaging changes and histopathological evidence; Infectious diseases such as malaria, typhoid, encephalitis, meningitis, etc. have specific infectious sources and characteristic clinical manifestations; Drug users had a history of taking drugs, and the more common drugs were glucocorticoid, dopamine, propranolol, etc; Other stressors included history of trauma, surgery, and poison exposure.
The incidence rate of the elderly is higher than that of the newborn. It is reported that the incidence rate of the elderly can reach 14% abroad. Nutritional status, anorexia, malnutrition, hunger, protein deficiency, etc. Acute and chronic diseases, infectious diseases, fever, acute myocardial infarction, chronic degenerative diseases, chronic diseases such as liver cirrhosis, chronic kidney disease and renal insufficiency, diabetes and other metabolic diseases, malignant tumors, etc. Severe trauma, anesthesia, surgery, etc.
matters needing attention
The prognosis depends on the primary disease. Low T3 is a sign of poor prognosis. For low T3 and low T4 syndrome, there is no definite conclusion whether th supplement therapy is beneficial or not. It was observed that serum T3 of 142 patients with coronary artery bypass grafting was normal before operation. Serum T3 decreased by 40% 30 min after bypass operation. After intravenous infusion of T3, serum T3 increased to more than normal level, and serum T3 returned to normal after operation, There was no difference in the incidence of arrhythmia and mortality between the two groups. Brent had observed the effect of L-T4 in 11 patients with severe NTIS and 12 patients as controls. There was no difference in the mortality between the two groups, This study shows that th, whether it is exogenous T3 or T4, has no effect on the prognosis of NTIS. The primary disease should be treated. After the recovery of the primary disease, the level of th can return to normal, unless the patient has primary thyroid disease.
