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Antemortem chemical hypothyroxinemia.

H J Bonnell

    Journal of Forensic Sciences
    |January 1, 1983
    PubMed
    Summary

    Hypothyroidism in intensive care unit (ICU) patients may not stem from thyroid gland issues. Chemical hypothyroxinemia, a decrease in thyroid hormone levels, was observed in most autopsy patients shortly before death.

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    Area of Science:

    • Endocrinology
    • Pathology
    • Critical Care Medicine

    Background:

    • Reports suggest hypothyroidism in intensive care unit (ICU) patients.
    • The underlying cause of this observed hypothyroidism requires investigation.

    Purpose of the Study:

    • To investigate the thyroid gland's condition and function in ICU patients nearing death.
    • To determine if histologic abnormalities or thyroid function test (TFT) changes correlate with critical illness.

    Main Methods:

    • Autopsy of 40 patients with no prior thyroid disease history.
    • Gross and microscopic examination of thyroid glands.
    • Thyroid function tests performed on serum specimens within seven days of death.

    Main Results:

    • All autopsy patients, except those with sudden cardiac death, exhibited chemical hypothyroxinemia within three days of death.
    • No histologic abnormalities of the thyroid gland were found.
    • Similar findings were observed when comparing decedents with matched survivor controls.

    Conclusions:

    • Chemical hypothyroxinemia in critically ill patients may be a consequence of illness severity rather than primary thyroid dysfunction.
    • Thyroid function tests in ICU settings should be interpreted cautiously, considering the potential for non-thyroidal illness syndrome.

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