11/29/2023 0 Comments Euthyroid sick syndrome treatment![]() ![]() As presented above, ESS represents "hypothyroid state" which is disadvantageous to patients because thyroid hormone plays important role during illness by controlling metabolic rate 13). This result showed a close relationship between mortality rate and the incidence of ESS after HSCT. In this study, mortality rate after HSCT was significantly higher in patients with ESS within 3 months during HSCT ( P=0.014) compared to the non-ESS group. The degree of alteration of thyroid hormones can predict the outcome in several disease processes 12, 13). Serum T 4 levels are reduced in ESS in proportion to the severity and probably the length of the illness 13). With few exceptions, reports indicate that serum T 3 level is low in patients with ESS. It is also called nonthyroidal illness syndrome (NTIS) 12, 13). ![]() A decrease in serum thyroid hormone level in ESS is often seen in stress-inducing conditions, such as starvation, sepsis, surgery, myocardial infarction, bone marrow transplantation, and, in fact, probably any severe illness. ![]() ESS was also reported as frequent shortterm thyroid dysfunction by Toubert et al. Among these 45 patients, ESS (64.4%, 29/45 patients) was the most common short-term thyroid dysfunction. ![]() In this study, short-term thyroid dysfunction was detected in 27.1% (45 out of 166) of the patients. All 8 chronic myelogenous leukemia patients underwent transplantation after the first chronic phase ( Table 1). Seventy-one patients with acute myeloid leukemia underwent transplantation after first complete remission, and 5 underwent transplantation after second complete remission. Twenty-one patients with acute lymphoblastic leukemia underwent transplantation after first complete remission and 22 patients underwent transplantation after second complete remission. Patients underwent HSCT for malignant and nonmalignant hematological diseases (43 acute lymphoblastic leukemia, 79 acute myeloid leukemia, 8 chronic myelogenous leukemia, 31 aplastic anemia, 5 Fanconi anemia, 3 hemophagocytic lymphohistiocytosis). Patients who were not evaluated for thyroid function (n=3), those with abnormal thyroid function before transplantation (n=28), those with solid tumor (n=13), and those who died within 3 months after HSCT (n=4) were excluded from the study. Mary's Hospital HSCT Center at the Catholic University of Korea from January 2004 through December 2009. These patients had undergone HSCT at Seoul St. Conclusions Low- dose levothyroxine sodium treatment is effective for ESS in patients with severe pulmonary tuberculosis.Improvement on low T3 syndrome may be an important indicator for the overall improvement or recovery.Out of 214 patients, 166 (100 females and 66 males) were included in the study. 3%), while no death was reported in treatment group. Two patients in control group died(2/60, 3. No empty closed after treatment in both groups, but the effective rate in treatment group was significantly higher than that in the control group(93.3% vs. T3 and FT3 were significantly increased in both groups, but more significant difference was observed in the treatment group(t = 59. Serum albumin in the treatment group was increased to(34.2 ☐.4)g/L after the treatment, and that in the control group was(29.1 ☐.6)g/L(t =2.42, P<0.05). Clearance rate of acid-fast bacilli in treatment group was 25.0%(15/60), but that in the control was only 6.7%(4/60)(χ2 = 7. Marked improvements were observed in 19 patients(31.7%)of treatment group and 8 patients (13.3%)of control group(χ2 = 5. Thyroid function, clinical improvements, increase of albumin, reduction of acid-fast bacilli, improvements on images and the mortality rates were compared between the groups.Results After 2 weeks of treatment, symptoms including fever, cough and night sweats were improved in both groups. Both groups were given anti- tuberculosis, antiinfection treatment and nutritional support for 2 weeks patients in treatment group were given low- dose levothyroxine sodium additionally. Methods One hundred and twenty inpatients with severe pulmonary tuberculosis and ESS were randomly divided into treatment group and control group by gender, age, disease duration and severity. Objective To evaluate the efficacy of low- dose levothyroxine sodium in treatment of severe pulmonary tuberculosis with euthyroid sick syndrome(ESS). ![]()
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