Related Experiment Videos

Thyroid function in children with sepsis and septic shock

Rakesh Lodha1, S Vivekanandhan, Manjunatha Sarthi

  • 1Departments of Pediatrics and Neurobiochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Acta Paediatrica (Oslo, Norway : 1992)
|April 5, 2007
PubMed

Insights

Children with septic shock exhibit lower thyroid hormone levels, including triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH), compared to those with sepsis. These thyroid function changes do not appear to significantly impact septic shock severity in pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Endocrinology
  • Infectious diseases

Background:

  • Sepsis and septic shock are life-threatening conditions in children.
  • Thyroid hormones play crucial roles in metabolic regulation and systemic response to critical illness.
  • The specific impact of thyroid hormone derangements on pediatric septic shock outcomes requires further investigation.

Purpose of the Study:

  • To determine thyroid hormone levels in children experiencing septic shock.
  • To compare thyroid hormone profiles between children with septic shock and those with sepsis.
  • To investigate the relationship between thyroid hormone levels and survival in pediatric septic shock.

Main Methods:

  • Prospective study design.
  • Measurement of thyroid hormones: triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4).
  • Comparison of hormone levels between pediatric patients with septic shock and sepsis, and between survivors and non-survivors of septic shock.

Main Results:

  • Children with septic shock presented with significantly lower median levels of T3, T4, fT3, fT4, and TSH compared to children with sepsis.
  • Elevated TSH levels were observed in pediatric septic shock patients who died compared to survivors (p = 0.04).
  • No significant differences in hormone levels were found between catecholamine-responsive and catecholamine-resistant septic shock groups.

Conclusions:

  • Pediatric septic shock is associated with suppressed thyroid hormone levels, distinct from sepsis alone.
  • Thyroid function derangements in children with septic shock do not appear to be a primary driver of disease severity.
  • Further research may elucidate the complex interplay between thyroid status and critical illness in pediatric populations.
Abstract

Related Concept Videos

Functions of Thyroid Hormones01:18

Functions of Thyroid Hormones

The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...