Background and Aim: The levels of thyroid hormones and their binding proteins are altered in patient with cirrhosis. We aim to study the changes in triiodothyronine level in HCV related cirrhosis and its correlation t...Background and Aim: The levels of thyroid hormones and their binding proteins are altered in patient with cirrhosis. We aim to study the changes in triiodothyronine level in HCV related cirrhosis and its correlation to the severity of liver decompensation. Patients and Methods: This study included seventy two patients with HCV related cirrhosis in three groups Group I: 24 patients with Child A class Group II: 24 patients with Child B and C classes without hepatic encephalopathy Group III: 24 patients with Child B and C classes with hepatic encephalopathy. Results: T3 level was significantly lower in group III than group I and II (0.74 ng/ml vs 1 and 1.3 ng/ml in group II and I in succession). The correlation between Child’s score and T3 level was highly significant (r = -0.64, P < 0.001). Conclusion: Triiodothyronine level is lower in cirrhosis and its level is correlated to the severity of decompensation.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Background:</strong> The <sup>99m</sup>TcO<sub>4</sub><sup style=&quo...<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Background:</strong> The <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy is commonly used for hyperthyroidism diagnosis. Uptake value of <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> on thyroid scintigraphy is an indicator of hyperthyroidism activity. Although, the correlation between free T3 value and free T4 value is not necessary clear in primary hyperthyroidism. <strong>Introduction: </strong>This study investigated the correlation between results of blood test and uptake of <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> on thyroid scintigraphy in primary hyperthyroidism. <strong>Methodlogy: </strong>In this retrspective study, uptake was calculated in patients diagnosed with primary hyperthyroidism (Graves’ disease/Basedow’s disease) based on clinical findings, blood tests, thyroid ultrasound, and <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy (uptake ≥3%) at St. Marianna University School of Medicine Hospital between 1 January 2010 and 31 December 2019. This uptake of <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> was compared with results of blood tests. <strong>Results:</strong> Fifty-four consecutively arriving patients at the hospital (12 men, 42 women;mean age 43.0 ± 14.0 years) were selected. Free T3 (n = 54) was 14.6 ± 6.8 pg/mL, free T4 (n = 53) was 5.0 ± 2.3 ng/mL, and uptake on thyroid scintigraphy was 10.0% ± 7.1%. The correlation coefficients were 0.60 (p < 0.01) between free T4 (all case), 0.39 (p < 0.01) between free T4 (under 7 ng/mL), 0.12 (p = 0.70) between free T4 (above 7 ng/mL) and <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy uptake. <strong>Conclusion:</strong> In primary hyperthyroidism (Graves’ disease), there is a correlation between free T4 value and <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy uptake, but there is no correlation in patients with high free T4 level.</span> </div>展开更多
Background: Low free T4 and normal/low TSH concentrations are often noted in clinical practice and denote presence of “Euthyroid Sick Syndrome” or Central Hypothyroidism. However, accurate diagnosis is difficult eve...Background: Low free T4 and normal/low TSH concentrations are often noted in clinical practice and denote presence of “Euthyroid Sick Syndrome” or Central Hypothyroidism. However, accurate diagnosis is difficult even with determination of free T3 being low/normal in both. Repeated determination of these tests may help differentiate between these disorders. Objective: Evaluation of reverse T3 to differentiate between “Euthyroid Sick Syndrome” and Central Hypothyroidism. Subjects and Methods: Free T3 and Reverse T3 were determined as “add on” tests using previously drawn blood samples of 78 consecutive adults showing low free T4, 0.80 ± 0.02 and low/normal TSH, 1.29 ± 0.40 [normal ranges, 0.89 - 1.70 mcg/dl;0.45 - 4.67 uU/ml]. Free T4, free T3, TSH and reverse T3 levels were also determined in age-matched 35 healthy volunteers and reassessed in study group. Statistical analyses for comparisons were conducted between groups. All data are reported as Mean ± SEM. Results: Reverse T3 established two distinct groups: 1) subnormal concentrations, 8.31 ± 0.52 [range, 11 - 14 ng/dl];2) supernormal levels;32 ± 4 [normal Range 12 - 26]. Free T3 concentrations were subnormal or normal, 1.6 - 2.9 [normal range, 2.3 - 4.2 ng/ml] in individuals amongst both groups. On reassessment after 3 - 6 weeks, free T4, free T3, TSH and reverse T3 normalized in group with normal or elevated reverse T3 indicating recovery from “Euthyroid Sick Syndrome” whereas free T4 and reverse T3 remained subnormal in the other group suggesting presence of Central Hypothyroidism. Conclusion: Reverse T3 is a reliable laboratory test differentiating between Central Hypothyroidism and “Euthyroid Sick Syndrome” in subjects with low free T4 and low/normal TSH levels.展开更多
文摘Background and Aim: The levels of thyroid hormones and their binding proteins are altered in patient with cirrhosis. We aim to study the changes in triiodothyronine level in HCV related cirrhosis and its correlation to the severity of liver decompensation. Patients and Methods: This study included seventy two patients with HCV related cirrhosis in three groups Group I: 24 patients with Child A class Group II: 24 patients with Child B and C classes without hepatic encephalopathy Group III: 24 patients with Child B and C classes with hepatic encephalopathy. Results: T3 level was significantly lower in group III than group I and II (0.74 ng/ml vs 1 and 1.3 ng/ml in group II and I in succession). The correlation between Child’s score and T3 level was highly significant (r = -0.64, P < 0.001). Conclusion: Triiodothyronine level is lower in cirrhosis and its level is correlated to the severity of decompensation.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Background:</strong> The <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy is commonly used for hyperthyroidism diagnosis. Uptake value of <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> on thyroid scintigraphy is an indicator of hyperthyroidism activity. Although, the correlation between free T3 value and free T4 value is not necessary clear in primary hyperthyroidism. <strong>Introduction: </strong>This study investigated the correlation between results of blood test and uptake of <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> on thyroid scintigraphy in primary hyperthyroidism. <strong>Methodlogy: </strong>In this retrspective study, uptake was calculated in patients diagnosed with primary hyperthyroidism (Graves’ disease/Basedow’s disease) based on clinical findings, blood tests, thyroid ultrasound, and <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy (uptake ≥3%) at St. Marianna University School of Medicine Hospital between 1 January 2010 and 31 December 2019. This uptake of <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> was compared with results of blood tests. <strong>Results:</strong> Fifty-four consecutively arriving patients at the hospital (12 men, 42 women;mean age 43.0 ± 14.0 years) were selected. Free T3 (n = 54) was 14.6 ± 6.8 pg/mL, free T4 (n = 53) was 5.0 ± 2.3 ng/mL, and uptake on thyroid scintigraphy was 10.0% ± 7.1%. The correlation coefficients were 0.60 (p < 0.01) between free T4 (all case), 0.39 (p < 0.01) between free T4 (under 7 ng/mL), 0.12 (p = 0.70) between free T4 (above 7 ng/mL) and <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy uptake. <strong>Conclusion:</strong> In primary hyperthyroidism (Graves’ disease), there is a correlation between free T4 value and <sup>99m</sup>TcO<sub>4</sub><sup style="margin-left:-7px;">-</sup> thyroid scintigraphy uptake, but there is no correlation in patients with high free T4 level.</span> </div>
文摘Background: Low free T4 and normal/low TSH concentrations are often noted in clinical practice and denote presence of “Euthyroid Sick Syndrome” or Central Hypothyroidism. However, accurate diagnosis is difficult even with determination of free T3 being low/normal in both. Repeated determination of these tests may help differentiate between these disorders. Objective: Evaluation of reverse T3 to differentiate between “Euthyroid Sick Syndrome” and Central Hypothyroidism. Subjects and Methods: Free T3 and Reverse T3 were determined as “add on” tests using previously drawn blood samples of 78 consecutive adults showing low free T4, 0.80 ± 0.02 and low/normal TSH, 1.29 ± 0.40 [normal ranges, 0.89 - 1.70 mcg/dl;0.45 - 4.67 uU/ml]. Free T4, free T3, TSH and reverse T3 levels were also determined in age-matched 35 healthy volunteers and reassessed in study group. Statistical analyses for comparisons were conducted between groups. All data are reported as Mean ± SEM. Results: Reverse T3 established two distinct groups: 1) subnormal concentrations, 8.31 ± 0.52 [range, 11 - 14 ng/dl];2) supernormal levels;32 ± 4 [normal Range 12 - 26]. Free T3 concentrations were subnormal or normal, 1.6 - 2.9 [normal range, 2.3 - 4.2 ng/ml] in individuals amongst both groups. On reassessment after 3 - 6 weeks, free T4, free T3, TSH and reverse T3 normalized in group with normal or elevated reverse T3 indicating recovery from “Euthyroid Sick Syndrome” whereas free T4 and reverse T3 remained subnormal in the other group suggesting presence of Central Hypothyroidism. Conclusion: Reverse T3 is a reliable laboratory test differentiating between Central Hypothyroidism and “Euthyroid Sick Syndrome” in subjects with low free T4 and low/normal TSH levels.
