Critically ill patients: Histopathological evidence of thyroid dysfunction

Area of Science:

• Endocrinology
• Pathology
• Critical Care Medicine

Background:

• Critical illness involves severe metabolic stress and systemic inflammation.
• Non-thyroidal illness (NTI) is frequently observed in critically ill patients.
• The cytomorphological basis of NTI requires further investigation.

Purpose of the Study:

• To investigate the histopathological changes in the thyroid gland of patients who died from critical illness.
• To elucidate the cytomorphological alterations associated with NTI in critical care settings.

Main Methods:

• Autopsy thyroid gland samples from 58 critically ill patients were examined.
• Cases included burn injury, traumatic brain injury, and cerebral stroke.
• Standard hematoxylin and eosin staining and light microscopy were employed.

Main Results:

• 21 out of 58 patients (36%) exhibited normal thyroid findings.
• The majority of cases showed significant histopathological alterations.
• Key findings included distorted thyroid follicular architecture, mononuclear cell infiltration, thyroglobulin clumping, and follicular exhaustion.

Conclusions:

• Critical illness induces metabolically damaging effects on the thyroid gland, consistent with low T3 syndrome.
• Thyroid changes were more pronounced in burn injury and cerebral stroke compared to traumatic brain injury.