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Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study
BACKGROUND: Euthyroid sick syndrome (ESS) is characterized by low serum levels of free triiodothyronine (fT3) with normal or low levels of thyroid stimulating hormone (TSH) and free thyroxine (fT4) and is reported in different acute clinical situations, such as sepsis, diabetic ketoacidosis and afte...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448823/ https://www.ncbi.nlm.nih.gov/pubmed/37635797 http://dx.doi.org/10.3389/fped.2023.1217151 |
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author | Fastiggi, Michele Meneghel, Alessandra Gutierrez de Rubalcava Doblas, Joaquin Vittadello, Fabio Tirelli, Francesca Zulian, Francesco Martini, Giorgia |
author_facet | Fastiggi, Michele Meneghel, Alessandra Gutierrez de Rubalcava Doblas, Joaquin Vittadello, Fabio Tirelli, Francesca Zulian, Francesco Martini, Giorgia |
author_sort | Fastiggi, Michele |
collection | PubMed |
description | BACKGROUND: Euthyroid sick syndrome (ESS) is characterized by low serum levels of free triiodothyronine (fT3) with normal or low levels of thyroid stimulating hormone (TSH) and free thyroxine (fT4) and is reported in different acute clinical situations, such as sepsis, diabetic ketoacidosis and after cardiac surgery. Our aim was to evaluate the predicting role of ESS for disease severity in patients with Multisystem Inflammatory Syndrome in children (MIS-C). METHODS: A single-centre observational study on consecutive patients with MIS-C. Before treatment clinical, and laboratory data were collected and, in a subset of patients, thyroid function tests were repeated 4 weeks later. Variables distribution was analyzed by Mann-Whitney U-test and correlations between different parameters were calculated by Spearman's Rho coefficient. RESULTS: Forty-two patients were included and 36 (85.7%) presented ESS. fT3 values were significantly lower in patients requiring intensive care, a strong direct correlation was shown between fT3 and Hb, platelet count and ejection fraction values. A significant inverse correlation was retrieved between fT3 levels and C-reactive protein, brain natriuretic peptide, IL-2 soluble receptor and S-100 protein. Subjects with severe myocardial depression (EF < 45%) had lower fT3 values than subjects with higher EF. The thyroid function tests spontaneously normalized in all subjects who repeated measurement 4 weeks after admission. CONCLUSION: ESS is a frequent and transient condition in acute phase of MIS-C. A severe reduction of fT3 must be considered as important prognostic factor for severe disease course, with subsequent relevant clinical impact in the management of these patients. |
format | Online Article Text |
id | pubmed-10448823 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104488232023-08-25 Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study Fastiggi, Michele Meneghel, Alessandra Gutierrez de Rubalcava Doblas, Joaquin Vittadello, Fabio Tirelli, Francesca Zulian, Francesco Martini, Giorgia Front Pediatr Pediatrics BACKGROUND: Euthyroid sick syndrome (ESS) is characterized by low serum levels of free triiodothyronine (fT3) with normal or low levels of thyroid stimulating hormone (TSH) and free thyroxine (fT4) and is reported in different acute clinical situations, such as sepsis, diabetic ketoacidosis and after cardiac surgery. Our aim was to evaluate the predicting role of ESS for disease severity in patients with Multisystem Inflammatory Syndrome in children (MIS-C). METHODS: A single-centre observational study on consecutive patients with MIS-C. Before treatment clinical, and laboratory data were collected and, in a subset of patients, thyroid function tests were repeated 4 weeks later. Variables distribution was analyzed by Mann-Whitney U-test and correlations between different parameters were calculated by Spearman's Rho coefficient. RESULTS: Forty-two patients were included and 36 (85.7%) presented ESS. fT3 values were significantly lower in patients requiring intensive care, a strong direct correlation was shown between fT3 and Hb, platelet count and ejection fraction values. A significant inverse correlation was retrieved between fT3 levels and C-reactive protein, brain natriuretic peptide, IL-2 soluble receptor and S-100 protein. Subjects with severe myocardial depression (EF < 45%) had lower fT3 values than subjects with higher EF. The thyroid function tests spontaneously normalized in all subjects who repeated measurement 4 weeks after admission. CONCLUSION: ESS is a frequent and transient condition in acute phase of MIS-C. A severe reduction of fT3 must be considered as important prognostic factor for severe disease course, with subsequent relevant clinical impact in the management of these patients. Frontiers Media S.A. 2023-08-10 /pmc/articles/PMC10448823/ /pubmed/37635797 http://dx.doi.org/10.3389/fped.2023.1217151 Text en © 2023 Fastiggi, Meneghel, Gutierrez de Rubalcava Doblas, Vittadello, Tirelli, Zulian and Martini. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Fastiggi, Michele Meneghel, Alessandra Gutierrez de Rubalcava Doblas, Joaquin Vittadello, Fabio Tirelli, Francesca Zulian, Francesco Martini, Giorgia Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study |
title | Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study |
title_full | Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study |
title_fullStr | Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study |
title_full_unstemmed | Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study |
title_short | Prognostic role of euthyroid sick syndrome in MIS-C: results from a single-center observational study |
title_sort | prognostic role of euthyroid sick syndrome in mis-c: results from a single-center observational study |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448823/ https://www.ncbi.nlm.nih.gov/pubmed/37635797 http://dx.doi.org/10.3389/fped.2023.1217151 |
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