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Ige OM, Akinlade KS, Rahamon SK, Edem VF, Arinola OG. Thyroid function in multidrug-resistant tuberculosis patients with or without human immunodeficiency virus (HIV) infection before commencement of MDR-TB drug regimen. Afr Health Sci 2016; 16:596-602. [PMID: 27605977 DOI: 10.4314/ahs.v16i2.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mycobacterium tuberculosis and human immunodeficiency virus (HIV) are known to cause abnormal thyroid function. There is little information on whether HIV infection aggravates alteration of thyroid function in patients with MDR-TB. OBJECTIVES This study was carried out to determine if HIV co-infection alters serum levels of thyroid hormones (T3, T4) and thyroid stimulating hormone (TSH) in patients with MDR-TB patients and to find out the frequency of subclinical thyroid dysfunction before the commencement of MDR-TB therapy. METHODS This observational and cross-sectional study involved all the newly admitted patients in MDR-TB Referral Centre, University College Hospital, Ibadan, Nigeria between July 2010 and December 2014. Serum levels of thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were determined using ELISA. RESULTS Enrolled were 115 patients with MDR-TB, out of which 22 (19.13%) had MDR-TB/HIV co-infection. Sick euthyroid syndrome (SES), subclinical hypothyroidism and subclinical hyperthyroidism were observed in 5 (4.35%), 9 (7.83%) and 2 (1.74%) patients respectively. The median level of TSH was insignificantly higher while the median levels of T3 and T4 were insignificantly lower in patients with MDR-TB/HIV co-infection compared with patients with MDRT-TB only. CONCLUSION It could be concluded from this study that patients with MDR-TB/HIV co-infection have a similar thyroid function as patients having MDR-TB without HIV infection before commencement of MDR-TB drug regimen. Also, there is a possibility of subclinical thyroid dysfunction in patients with MDR-TB/HIV co-infection even, before the commencement of MDR-TB therapy.
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Affiliation(s)
- Olusoji Mayowa Ige
- Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Kehinde Sola Akinlade
- Deaprtment of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Sheu Kadiri Rahamon
- Deaprtment of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Victory Fabian Edem
- Deaprtment of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria
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Kakavas S, Balis E, Papanikolaou A, Tatsis N, Kouvela M, Tatsis G. Triiodothyronine levels in acute pulmonary embolism predict in-hospital mortality. JOURNAL OF ACUTE DISEASE 2015. [DOI: 10.1016/j.joad.2015.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Mansourian AR. A review of literatures on the adverse effects of thyroid abnormalities and liver disorders: an overview on liver dysfunction and hypothyroidism. Pak J Biol Sci 2013; 16:1641-1652. [PMID: 24506031 DOI: 10.3923/pjbs.2013.1641.1652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The healthy thyroid is vital for the liver metabolism. The liver also plays an important role in the metabolism of thyroid hormones. Thyroid and liver diseases can apparently have an adverse effects on each other organs. The main concept behind this present review is to analyze the coordination existed among thyroid and liver and the pathophysiology surrounding these two vital organs in human metabolism.
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Affiliation(s)
- Azad Reza Mansourian
- Department of Biochemistry, Metabolic Disorders Research Center, Gorgan Medical School, Golestan University of Medical Sciences, Gorgan, Iran
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Shoukry A, Said NS, Ayman Abd-Elrahman M, Saber T, Amany Fawzy M, Shalaby S. Thyroid dysfunction and inflammatory biomarkers in chronic obstructive pulmonary disease: Relation to severity and exacerbation. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2013. [DOI: 10.1016/j.ejcdt.2013.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Aras G, Kadakal F, Purisa S, Kanmaz D, Aynaci A, Isik E. Are we aware of restless legs syndrome in COPD patients who are in an exacerbation period? Frequency and probable factors related to underlying mechanism. COPD 2012; 8:437-43. [PMID: 22149404 DOI: 10.3109/15412555.2011.623737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A few previous studies have reported that the patients with chronic obstructive pulmonary disease (COPD) have a 29.1% to 36.8% frequency of restless legs syndrome (RLS). In this study, we observed RLS symptoms in patients experiencing COPD exacerbation to better understand the relationship between the many clinical parameters of COPD and the presence of RLS and to attract the attention of specialists on the association between the two conditions. Twenty-two male patients in COPD exacerbation; 17 healthy individuals were evaluated in this study. The patients were evaluated using the 2003 RLS symptom criteria outlined by the International Restless Legs Syndrome Study Groups (IRLSSG). The Pittsburgh Sleep Quality Index and Epworth daytime sleepiness scale were used to assess the sleep quality of patients. The RLS symptoms were correlated with blood levels of laboratory and clinical parameters. Statistical analyses were performed using SPSS 17.0 statistical software packet. The Pittsburgh Sleep Quality Index and Epworth daytime sleepiness scale scores were increased in COPD patients and correlated significantly with RLS symptoms. It was found that 54.5% of COPD patients with acute exacerbations were observed to have RLS symptoms. The Pittsburgh Sleep Quality Index was significantly higher in COPD patients with RLS symptoms compared to COPD patients without RLS symptoms (p < 0.05). We did not observe any significant difference in the previously reported metabolic and clinical parameters associated with RLS in COPD patients with and without RLS. RLS symptoms increase during COPD exacerbation and lead to decreased sleep quality.
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Affiliation(s)
- Gulfidan Aras
- Yedikule Chest Disease and Surgery Education and Research Hospital, Istanbul, Turkey.
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Goldsmit GS, Valdes M, Herzovich V, Rodriguez S, Chaler E, Golombek SG, Iorcansky S. Evaluation and clinical application of changes in thyroid hormone and TSH levels in critically ill full-term newborns. J Perinat Med 2011; 39:59-64. [PMID: 20979446 DOI: 10.1515/jpm.2010.120] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The term "euthyroid sick syndrome" (ESS) has been used to describe a pattern of thyroid hormone changes during the course of critical illness in adult patients without thyroid disease, often associated with reduced thyroid hormone secretion. OBJECTIVE To describe the thyroid hormone profile in full-term newborns critically ill compared with thyroid hormone profile of healthy infants, and determine if alterations could be related to the severity of the disease and outcome. METHODS A cross-sectional, observational, and prospective study of full-term infants admitted to the neonatal intensive care unit (NICU) of the Hospital de Pediatría J.P. Garrahan between July 2007 and April 2008. Serum T3, T4, and thyroid stimulating hormone (TSH) levels were measured at admission and severity of the disease was evaluated through SNAP, lactic acid, respiratory assistance and number of organs affected. RESULTS Sick newborns showed significantly lower T3 and T4 levels compared with healthy infants [T3: -0.97 μg/dL (95% CI -0.89, -1.13) and T4: -4.37 μg/dL (95% CI -2.95, -5.78)]. Only 29 out of 94 (31%) infants presented a normal profile; 37 (39%) infants showed isolated low T3 levels, 20 (21%) infants had low T3 and T4 levels and eight (9%) infants had low TSH, T3, and T4. Of this latter group, five of eight (62%) children died suggesting a significantly higher risk of death for patients with low T3 associated with low T4 and TSH [Risk ratio (RR) 10.75 95% CI 3.93, 29]. CONCLUSIONS Full-term sick newborns frequently have lower thyroid hormone levels than healthy ones. These observed thyroid hormones changes might be related to the underlying disease and could be used as a prognostic marker of the severity and fatal outcome of the patient.
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Affiliation(s)
- Gustavo S Goldsmit
- Neonatology, Hospital Nacional de Pediatria JP Garrahan, Buenos Aires, Argentina
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Xin Y, Yang M, Chen XJ, Tong YJ, Zhang LH. Clinical features at the onset of childhood type 1 diabetes mellitus in Shenyang, China. J Paediatr Child Health 2010; 46:171-5. [PMID: 20546479 DOI: 10.1111/j.1440-1754.2009.01657.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To describe the clinical picture and laboratory features of Chinese children with newly diagnosed type 1 diabetes mellitus. METHODS The clinical and laboratory data of a total of 203 children who presented with newly diagnosed type 1 diabetes mellitus during a 5-year period (2004-2008) were retrospectively analysed based on hospital records. RESULTS There were 88 boys (43.3%) and 115 girls (56.7%) with a median age of 8.3 years. The age distribution was categorised as 0-4 years: 52 (25.6%), 5-9 years: 57 (28.1%) and 10-14 years: 94 (46.3%). We found a peak incidence rate in the older age group. No significant seasonality was observed. The most common symptoms were polydipsia, polyuria and weight loss. Eighty-five (41.9%) of all patients presented with diabetic ketoacidosis (DKA). The average duration of presenting symptoms before the hospital encounter was 24.5 days. Young age group children had shorter duration (17.1 days, P = 0.03) and significantly lower levels of C-peptide (P = 0.003) and haemoglobin A1c (P = 0.049) than the other groups. Children with DKA had a higher incidence of preceding infections (P = 0.032), lower free triiodothyronine and free thyroxine levels (P= 0.035, 0.046), and higher white blood cell counts (P = 0.000) than the non-DKA group. CONCLUSION The duration between the onset of the symptoms and diagnosis was long, and the proportion of DKA in children with newly diagnosed diabetes mellitus was high. These findings call for a collaborative effort for the early recognition of symptoms by patients and physicians in order to avoid more severe types of presentation.
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Affiliation(s)
- Ying Xin
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
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Cho HK, Sohn JA, Kim HS, Sohn S. Low T3 syndrome in Kawasaki disease: Relation to serum levels of tumor necrosis factor-α, interleukin-6 and NT-proBNP. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.2.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hye Kyung Cho
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jin A Sohn
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sejung Sohn
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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Satar D, Satar S, Mete UO, Suchard JR, Topal M, Karakoc E, Kaya M. Ultrastructural changes in rat thyroid tissue after acute organophosphate poisoning and effects of antidotal therapy with atropine and pralidoxime: A single-blind, ex vivo study. Curr Ther Res Clin Exp 2008; 69:334-42. [PMID: 24692810 DOI: 10.1016/j.curtheres.2008.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2008] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Organophosphate (OP) insecticides are widely used in both agricultural and landscape pest control, and the potential for human exposure to these compounds is significant. OBJECTIVES The aims of this study were to investigate the effects of acute poisoning with the OP methamidophos and the effects of antidotal therapy with atropine and pralidoxime on rat thyroid tissue ultrastructure. METHODS In this single-blind, ex vivo study, male Wistar albino rats weighing 220 to 230 g were divided into 4 treatment groups. Group 1 received a median lethal dose of methamidophos (30 mg/kg) via oral gavage. Group 2 received saline via oral gavage and served as the control group for group 1. Group 3 received methamidophos (30 mg/kg) via oral gavage, and after 8 minutes atropine 0.05 mg/kg and pralidoxime chloride (2-FAM) (40 mg/kg) were administered intraperitoneally (IP). Atropine was titrated to reverse signs of cholinergic excess. Group 4 received saline via oral gavage followed by IP injections and served as the control for group 3. Rat thyroid tissues were examined using electron microscopy, and the histologic changes were examined by a histopathologist who was blinded to treatment. All rats were euthanized by intracardiac blood collection. The rats in groups 1 and 2 were euthanized 8 minutes after treatment. The rats in groups 3 and 4 were euthanized 96 hours after treatment. RESULTS Thirty-four male rats (aged 16 weeks) were included in the study. The rats were grouped accordingly: group 1 (n = 10); group 2 (n = 7); group 3 (n = 10); and group 4 (n = 7). The mean (SD) pseudocholinesterase (FCE) activity was significantly lower in the methamidophos-treated rats (group 1) compared with the corresponding control group (group 2) (32.6 [17.0] vs 579.4 [59.0] U/L, respectively; P < 0.001). PCE activity was significantly higher in rats treated with atropine and 2-PAM (group 3) (392.5 [39.4] U/L; P < 0.001) compared with those not receiving antidotal therapy (group 1). Group 1 experienced changes in thyrocytes and organelles that were not detected in the antidote-treated rats in group 3. These changes included follicular cell nuclei exhibiting an increase in chromatin content, pyknotic nuclei, mitochondrial degeneration, dilated granular endoplasmic reticulum cisternae, reduced microvilli, and intraluminal cellular debris. Within follicular cells, formation of vacuoles filled with fine granular material was noted. CONCLUSION Acute OP poisoning was associated with histopathologic effects in rat thyroid tissue that appeared to be mitigated by antidotal therapy in this small animal study. More extensive studies using immunohistochemical methods are needed.
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Affiliation(s)
- Deniz Satar
- Pathology Department, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Salim Satar
- Department of Emergency Medicine, Cukurova University School of Medicine, Adana, Turkey
| | - Ufuk Ozgu Mete
- Department of Histology and Embryology, Cukurova University School of Medicine, Adana, Turkey
| | - Jeffrey R Suchard
- Department of Emergency Medicine, University of California Irvine Medical Center, Orange, California
| | - Metin Topal
- Department of Emergency Medicine, Cukurova University School of Medicine, Adana, Turkey
| | - Emre Karakoc
- Department of Medical Intensive Care, Cukurova University School of Medicine, Adana, Turkey
| | - Mehmet Kaya
- Department of Histology and Embryology, Cukurova University School of Medicine, Adana, Turkey
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Bayarri VM, Sancho S, Campos C, Faus R, Simón JM, Porcar E, Tormo C, Hernandez A. [The euthyroid sick syndrome in severe acute illness]. Presse Med 2007; 36:1550-6. [PMID: 17448627 DOI: 10.1016/j.lpm.2007.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Accepted: 08/31/2006] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe euthyroid sick syndrome (ESS) and its different clinical variants in severe acute illness. DESIGN This prospective cohort study examined hormone results and outcome for patients admitted to our intensive care unit (ICU). METHODS In this heterogeneous group of 108 patients from our ICU we analyzed the prevalence of ESS and its influence on mortality and sought to determine if any thyroid indicators had a prognostic value. RESULTS The prevalence of ESS was similar to that described by other authors (68.5% for ESS type I, 15.7% for type II and 1.9% for type III). Patients developed thyroid alterations on their third day of hospitalization and those with ESS type II had a higher mortality rate. The only thyroid indicator with prognostic value was a reverse triiodothyronine (rT3) value exceeding 0.61 ng/mL. CONCLUSION Severe acute illness induced the thyroid alterations known as ESS. Type I had the highest prevalence, but type II was correlated with a higher mortality rate. The only thyroid indicator with a prognostic value was rT3.
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Pingitore A, Landi P, Taddei MC, Ripoli A, L'Abbate A, Iervasi G. Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med 2005; 118:132-6. [PMID: 15694896 DOI: 10.1016/j.amjmed.2004.07.052] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2003] [Accepted: 07/11/2004] [Indexed: 11/23/2022]
Abstract
PURPOSE We sought to explore the use of triiodothyronine (T(3)) concentrations as an adjunct to clinical and functional parameters when estimating prognosis in patients with chronic heart failure. METHODS We enrolled 281 patients with postischemic (n = 153) or nonischemic (n = 128) dilated cardiomyopathy. Total and free T(3) concentrations, and traditional clinical and functional cardiac parameters, were measured 2 to 5 days after hospital admission. A multivariate model was utilized to predict all-cause and cardiac mortality. RESULTS All-cause mortality was 23% (n = 64) after a mean (+/-SD) of 12 +/- 7 months of follow-up; 47 (73%) of the patients died from cardiac causes. The mean ejection fraction was lower in those patients who died than in those who survived (26% +/- 8% vs. 31% +/- 8%, P < 0.001), as were levels of total T(3) (1.0 +/- 0.4 nmol/L vs. 1.3 +/- 0.3 nmol/L, P < 0.001) and free T(3) (3.2 +/- 1.4 pmol/L vs. 3.7 +/- 1.0 pmol/L, P < 0.001). In a multivariate model, ejection fraction (odds ratio [OR] = 2.0 per 10% decrease; 95% confidence interval [CI]: 1.4 to 2.8 per 10% decrease; P < 0.001) and total T(3) level (OR = 0.3 per 1-nmol/L increase; 95% CI: 0.1 to 0.5 per 1-nmol/L increase; P < 0.001) were the only independent predictors of all-cause mortality. In an alternative model using free T(3) levels, ejection fraction (OR = 1.9; 95% CI: 1.4 to 2.7; P < 0.001) and free T(3) level (OR = 0.6 per 1 pmol/L; 95% CI: 0.5 to 0.8 per 1 pmol/L; P <0.02) were associated with all-cause mortality. When we considered cardiac mortality alone, male sex (OR = 3.5; 95% CI: 1.7 to 13; P < 0.04), ejection fraction (OR = 1.7; 95% CI: 1.2 to 2.5; P < 0.006), and total T(3) level (OR = 0.3; 95% CI: 0.2 to 0.7; P < 0.002) were independent predictors with the multivariate model. CONCLUSION Low T(3) levels are an independent predictor of mortality in patients with chronic heart failure, adding prognostic information to conventional clinical and functional cardiac parameters.
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Livingstone C, Phillips M, Davis J, Marvin V, Stebbing JF. Failure to gain weight on long-term parenteral nutrition attributed to tri-iodothyronine thyrotoxicosis. Nutrition 2004; 20:1018-21. [PMID: 15561493 DOI: 10.1016/j.nut.2004.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2004] [Accepted: 06/22/2004] [Indexed: 10/26/2022]
Abstract
We describe the case of a 49-y-old female patient on long-term parenteral nutrition after abdominal surgery who failed to gain weight despite nutritional provision in excess of theoretical requirements. On investigation, she was found to have a negative nitrogen balance (-5.9 g) and to have a tri-iodothyronine thyrotoxicosis but without many of the typical clinical features of hyperthyroidism. The patient also had mild hypercalcemia and hyperphosphatemia, which resolved fully after mobilization and treatment of the thyrotoxicosis. A derangement of the liver function tests was observed, which worsened progressively during parenteral nutrition but resolved promptly at its discontinuation. This case illustrates the importance of carrying out appropriate investigations including all thyroid function tests on patients who fail to gain weight on nutritional support.
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Affiliation(s)
- Callum Livingstone
- Department of Clinical Biochemistry, Royal Surrey County Hospital, Guildford, Surrey, UK.
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Affiliation(s)
- B J Dong
- University of California, San Francisco, School of Pharmacy 94143-0622, USA.
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