| The nonthyroidal illness syndrome in the non-critically ill patient. | |
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MedLine Citation:
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PMID: 20964678 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: The nonthyroidal illness syndrome (NTIS) is a very common clinical entity among hospitalized patients and has been reported in practically every severe illness and acute or chronic stressful event. There is a large body of data associating the presence of NTIS with the severity of the underlying disease. Most of these studies concern intensive care unit (ICU) patients, whereas the non-critically ill patients outside the ICU setting are less well studied. DESIGN: We provide a review of the existing literature focusing on studies examining NTIS in non-critically ill patients and attempt to summarize the pathophysiological pathways underlying the syndrome, its prognostic role, as well as the current intervention studies mainly from a clinical standpoint. RESULTS: The aetiology of the NTIS is multifactorial and varies among different groups of patients. Experimental and clinical findings suggest that inflammatory cytokines are implicated in the pathogenesis of the syndrome, whereas recent evidence re-evaluate the role of deiodinases in thyroid hormone metabolism not only in the periphery but also in the hypothalamus and the pituitary and thus in the alterations accompanying NTIS. Clinical data examining the effectiveness of thyroid hormone supplementation in NTIS remain controversial. CONCLUSIONS: As long as there is no clear evidence of benefit from thyroid hormone replacement and until well-designed studies confirm its efficacy, thyroxine supplementation should not be recommended for the treatment of NTIS. |
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Authors:
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Theodora A Pappa; Apostolos G Vagenakis; Maria Alevizaki |
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Publication Detail:
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Type: Journal Article Date: 2010-10-21 |
Journal Detail:
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Title: European journal of clinical investigation Volume: 41 ISSN: 1365-2362 ISO Abbreviation: Eur. J. Clin. Invest. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0245331 Medline TA: Eur J Clin Invest Country: England |
Other Details:
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Languages: eng Pagination: 212-20 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. European Journal of Clinical Investigation © 2010 Stichting European Society for Clinical Investigation Journal Foundation. |
Affiliation:
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Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, Athens, Greece. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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