Study of Sick Euthyroid Syndrome in Organophosphate Poisoning

Sick euthyroid syndrome is abnormal findings of thyroid function tests that occur among patients with non thyroid illness with reduced level of hormones like T3 (Triiodothyronine) among acute illness of poisoning and can be detected in blood within 2 hours after acute illness. As the disease progress there is severe manifestation of syndrome associated with hypothyroidism specially with T3 and T4 while, the level of TSH are slightly elevated or are not influenced. The Present study was carried out to assess the incidence of sick euthyroid syndrome in organophosphate poisoning as well to assess the socio demographic and clinical profile of patients with organophosphate poisoning.

This study was carried out at a tertiary care center for period of one year from January to December 2020 in a sample size of 74 patients(>18 years) admitted in ICU with the history of Organophosphate poisoning. Hemogram and thyroid profile and liver and kidney function of the patients were studied including assessment of gastric aspirates.

Out of 74 patients, majority of them were males (62%) in the age group of 21 to 30 years (42%), with organophosphate (64%) followed by carbamates (15%). The incidence of sick euthyroid syndrome with organophosphate poisoning was 53%. The mean serum cholinesterase in poisoning was 913±15.3. The factors which are statistically associated with sick euthyroidism were Male (20 to 40 years), low serum cholinesterase, no prior treatment, ECG changes and miosis.

Organophosphate poisoning is more common among young males with incidence of sick euthyroid being quite high among these patients. Pesticide poisoning is more common among young adult males in the age group of 20 to 40 years with the motive of suicidal tendency. The incidence of euthyroidism among organophosphate poisoning is quite high. The biochemical investigations in our study shows an elevation in organophosphate poisoning. This can be used as an indicator to assess the severity of poisoning. The serum cholinesterase and thyroid investigation can also be used as prognostic markers in assessment of severity of organophosphate poisoning. Hence, we conclude that biochemical markers and thyroid investigations helps in assessing mortality and prompt treatment of organophosphate poisoning.