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Pediatria Polska - Polish Journal of Paediatrics
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2/2022
vol. 97
 
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abstract:
Original paper

Evaluation of thyroid hormones and thyroid-stimulating hormone levels in critically ill full-term newborns

Zahraa M. Ezz El-Din
1
,
Emad El-Din E. Salama
2
,
Fatma A. Elmougy
3
,
Amany Ibrahim
1
,
Hala Youssef
2
,
Amal M. Mohy El-Din
1

  1. Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
  2. Department of Pediatrics, National Research Centre, Cairo, Egypt
  3. Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Pediatr Pol 2022; 97 (2): 89-94
DOI: https://doi.org/10.5114/polp.2022.114709
Online publish date: 2022/06/10
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Aim of the study
This study aimed to define the thyroid hormone characteristics in full-term critically ill neonates versus healthy neonates to evaluate the incidence of the euthyroid sick syndrome (ESS).

Material and methods
The present case-control study recruited 30 neonates presenting with manifestations of severe critical illness and a similar number of healthy controls. Patients were subjected to TT3, TT4, TSH, and FT4 testing.

Results
For the whole group of cases at the first sample the TT3-1 level was significantly lower than that of controls (85.63 ±33.380 ng/dl, 115.03 ±30.310 ng/dl, respectively) with a highly significant difference. The TT4-1 in cases on admission showed a highly significant difference to that of controls (7.607 ±2.2789 µg/dl, 11.219 ±2.088 µg/dl, respectively) (p < 0.01). TSH-1 in cases on admission was higher (6.573 ±6.6766 µIU/ml) than that of controls (3.964 ±4.5748 µIU/ml), but this did not show a significant difference (p > 0.05). In the second sample (5-6 days after the beginning of illness), TT3-2 (104.23 ±42.592 ng/dl) was still significantly less than that of controls (115.03 ±30.310 ng/dl), with a p-value < 0.05. TT4-2 (8.20 ±2.646), and still significantly lower than that of controls (11.219 ±2.088 µg/dl) with p-value < 0.05. TSH-2 in cases was higher (5.57 ±5.836 µIU/ml) than that of controls (3.964 ±4.5748 µIU/ml) with no significant difference (p > 0.05).

Conclusions
Critical illnesses are hallmarked by changes in circulating thyroid hormone parameters in full-term neonates with low TT3 concentrations in the absence of elevated TSH. The critically ill cases had a worse thyroid hormonal profile from the beginning of the disease until death compared with those who survived.

keywords:

euthyroid sick syndrome, critical illness, thyroid functions