WordNet

deeply affected by a strong feeling; "sat completely still, sick with envy"; "she was sick with longing"
people who are sick; "they devote their lives to caring for the sick"
intentionally so written (used after a printed word or phrase)
urge to attack someone; "The owner sicked his dogs on the intruders"; "the shaman sics sorcerers on the evil spirits" (同)set
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"

PrepTutorEJDIC

(人が)『病気の』;(部屋などが)病人の[ための];(顔色などが)病気を示す(思わせる) / 《名詞的に》《the ~;複数扱い》病人 / 《補語にのみ用いて》《おもに英》(…で)むかついて,吐き気を催して,気分が悪い《+『at(『with』,『from』+『名』(do『ing』)》 / 《補語にのみ用いて》(…に)『うんざりして』,あきあきして,いや気がさして;(…に)しゃくにさわって,腹が立って《+『of』+『名』(do『ing』)》 / 《補語にのみ用いて》(…に)『がっかりして』,落胆して《+『at』(『about』)+『名』(do『ing』)》 / 《補語にのみ用いて》(…を)熱望して,こがれて《+『for』+『名』》 / 病的な,異常心理の;気味の悪い
原文のまま(疑わしいまたは誤った原文をそのまま引用するときにつける)
…‘を'攻撃する / (…に対して)〈人・犬〉‘を'けしかける《+『名』〈人・犬〉+『on』+『名』》
(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
=ti

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/14 20:28:05」(JST)

wiki en

Euthyroid sick syndrome (ESS), sick euthyroid syndrome (SES), thyroid allostasis in critical illness, tumours, uremia and starvation (TACITUS), non-thyroidal illness syndrome (NTIS) or low T₃ low T₄ syndrome is a state of adaptation or dysregulation of thyrotropic feedback control^[1] where the levels of T3 and/or T4 are at unusual levels, but the thyroid gland does not appear to be dysfunctional.

This condition is often seen in starvation, critical illness or patients in intensive care unit. The most common hormone pattern in sick euthyroid syndrome is a low total and unbound T3 levels with normal T4 and TSH levels.

Causes

Causes of euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, chronic renal failure, cirrhosis, and diabetic ketoacidosis.^[1]

Euthyroid sick syndrome (non-thyroidal illness syndrome) has been assumed closely related with a series of diseases, (such as inflammatory bowel disease).^[2]

Mechanisms

In critical illness the activity of peripheral type I deiodinase is downregulated, while both the central Type 2 deiodinase and type 3 deiodinase activities are upregulated. Humoral and neuronal inputs at the level of the hypothalamus may adjust the set point of thyroid homeostasis. This may play an important role in the pathogenesis of the central component of TACITUS.^[3] In addition, both illness and medication (e.g. salicylates and heparin) may impair plasma protein binding of thyroid hormones, resulting in reduced levels of total hormones, while free hormone concentrations may be temporarily elevated.

Diagnosis

Affected patients may have normal, low, or slightly elevated TSH depending on the spectrum of illness. Total T4 and T3 levels may be altered by binding protein abnormalities, and medications. Reverse T3 levels are generally increased signifying inhibition of normal type 1 deiodinase or reduced clearance of reverse T3. Correspondingly, in the majority of cases calculated sum activity of peripheral deiodinases (SPINA-GD) is reduced.^[2]^[4]^[5]^[6] Generally the levels of free T3 will be lowered, followed by the lowering of free T4 in more severe disease. Several studies described elevated concentrations of 3,5-T2, an active thyroid hormone, in NTIS.^[6]^[7] 3,5-T2 levels were also observed to correlate with concentrations of rT3 (reverse T3)^[6] in patients with euthyroid sick syndrome.

TACITUS syndrome is a component of a complex endocrine adaptation process. Therefore, affected patients might also have hyperprolactinemia and elevated levels of corticosteroids (especially cortisol) and growth hormone.

Treatment

Several trials investigated a possible therapy for ESS. However, they yielded inconsistent and partly contradictory results. This may be caused in the fact that the investigated populations were too heterogeneous in the lack of a consistent definition of non-thyroid illness syndrome.^[8]

References

^ ^a ^b "Euthyroid Sick Syndrome: Thyroid Disorders: Merck Manual Professional". Retrieved 2009-03-29.
^ ^a ^b Liu, S; Ren, J; Zhao, Y; Han, G; Hong, Z; Yan, D; Chen, J; Gu, G; Wang, G; Wang, X; Fan, C; Li, J (February 2013). "Nonthyroidal illness syndrome: is it far away from Crohn's disease?". Journal of Clinical Gastroenterology 47 (2): 153–9. doi:10.1097/MCG.0b013e318254ea8a. PMID 22874844.
^ Hoermann, R; Midgley, JE; Larisch, R; Dietrich, JW (2015). "Homeostatic Control of the Thyroid-Pituitary Axis: Perspectives for Diagnosis and Treatment.". Frontiers in Endocrinology 6: 177. doi:10.3389/fendo.2015.00177. PMID 26635726.
^ Rosolowska-Huszcz D, Kozlowska L, Rydzewski A (August 2005). "Influence of low protein diet on nonthyroidal illness syndrome in chronic renal failure". Endocrine 27 (3): 283–8. doi:10.1385/ENDO:27:3:283. PMID 16230785.
^ Han G, Ren J, Liu S, Gu G, Ren H, Yan D, Chen J, Wang G, Zhou B, Wu X, Yuan Y, Li J. Nonthyroidal illness syndrome in enterocutaneous fistulas. Am J Surg. 2013 Sep;206(3):386-92 doi:10.1016/j.amjsurg.2012.12.011. PMID 23809674.
^ ^a ^b ^c Dietrich, JW; Müller, P; Schiedat, F; Schlömicher, M; Strauch, J; Chatzitomaris, A; Klein, HH; Mügge, A; Köhrle, J; Rijntjes, E; Lehmphul, I (2015). "Nonthyroidal Illness Syndrome in Cardiac Illness Involves Elevated Concentrations of 3,5-Diiodothyronine and Correlates with Atrial Remodeling". European Thyroid Journal 4: 129–37. doi:10.1159/000381543. PMC 4521060. PMID 26279999.
^ Pinna G, Meinhold H, Hiedra L, Thoma R, Hoell T, Gräf KJ, Stoltenburg-Didinger G, Eravci M, Prengel H, Brödel O, Finke R, Baumgartner A. Elevated 3,5-diiodothyronine concentrations in the sera of patients with nonthyroidal illnesses and brain tumors. J Clin Endocrinol Metab. 1997 May;82(5):1535-42. PMID 9141546.
^ Dietrich, JW; Stachon, A; Antic, B; Klein, HH; Hering, S (2008). "The AQUA-FONTIS study: protocol of a multidisciplinary, cross-sectional and prospective longitudinal study for developing standardized diagnostics and classification of non-thyroidal illness syndrome". BMC endocrine disorders 8: 13. doi:10.1186/1472-6823-8-13. PMC 2576461. PMID 18851740.

External links

McIver B, Gorman C (1997). "Euthyroid sick syndrome: an overview". Thyroid 7 (1): 125–32. doi:10.1089/thy.1997.7.125. PMID 9086580.
Overview at vghtc.gov.tw
Overview at merck.com

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 非甲状腺疾患における甲状腺機能 thyroid function in nonthyroidal illness
2. 甲状腺機能正常型高サイロキシン血症および低サイロキシン血症 euthyroid hyperthyroxinemia and hypothyroxinemia
3. 拒食症：内分泌合併症と患者のマネージメント anorexia nervosa endocrine complications and their management
4. 甲状腺機能亢進症の診断 diagnosis of hyperthyroidism
5. 甲状腺疾患患者の非甲状腺手術 nonthyroid surgery in the patient with thyroid disease

English Journal

Occult endocrine dysfunction in patients of cerebrovascular accident.

Kumar KV1, Kumar S2, Ahmad FM3.
Annals of Indian Academy of Neurology.Ann Indian Acad Neurol.2016 Jan-Mar;19(1):94-8. doi: 10.4103/0972-2327.167707.
BACKGROUND: Cerebrovascular disorders are common conditions leading to significant morbidity and mortality in the population. Occult endocrine disorders also contribute to the morbidity and we studied the prevalence of endocrine dysfunction in patients of cerebrovascular accident (CVA).MATERIALS AND
PMID 27011637

Emerging pharmacotherapy for treatment of traumatic brain injury: targeting hypopituitarism and inflammation.

Paterniti I1, Cordaro M2, Navarra M3, Esposito E1, Cuzzocrea S1,4.
Expert opinion on emerging drugs.Expert Opin Emerg Drugs.2015 Dec;20(4):583-96. doi: 10.1517/14728214.2015.1058358. Epub 2015 Jun 18.
INTRODUCTION: Traumatic brain injury (TBI) is a common cause of morbidity and mortality in the developed world. In particular, TBI is an important cause of death and disability in young adults with consequences ranging from physical disabilities to long-term cognitive, behavioural, psychological and
PMID 26087316

[Euthyroid sick syndrome as a risk factor for mortality in critically ill patient].

Muñoz-Ramirez MD1, Ortega-Valdez CA2, Murillo-Heredia E2.
Medicina clinica.Med Clin (Barc).2015 Oct 28. pii: S0025-7753(15)00483-2. doi: 10.1016/j.medcli.2015.09.002. [Epub ahead of print]
PMID 26520613

Japanese Journal

術前・術後管理開心術後のショックに対して有効であったステロイド補充療法

伊藤俊一郎,服部隆司,重田治 [他]
胸部外科 63(3), 204-207, 2010-03
NAID 40017005197

Coexistence of Corticotroph Adenoma and Thyrotroph Hyperplasia in a Dog(Surgery)

Teshima Takahiro,Hara Yasushi,Shigihara Kae [他],TAKEKOSHI Susumu,NEZU Yoshinori,HARADA Yasuji,YOGO Takuya,TERAMOTO Akira,OSAMURA Robert Y.,TAGAWA Masahiro
The journal of veterinary medical science 71(1), 93-98, 2009-01-25
… In dogs with Cushing's disease, many cases have low serum thyroid hormones concentrations due to euthyroid sick syndrome. …
NAID 110007055403

Nutritional and Prognostic Significance of Sick Euthyroid Syndrome in Non-small Cell Lung Cancer Patients

EkremCengiz Seyhan,Cetinkaya Erdogan,Altin Sedat,Gunluoglu Zeki,Demir Adalet,Gunluoglu Gulsah,Epozturk Kursat
Internal Medicine 47(4), 211-216, 2008
… Objectives Our study aimed to determine the frequency of sick euthyroid syndrome (SES) among patients diagnosed as non-small cell lung cancer (NSCLC) and its association with the stage of the disease, Karnofsky index (KI), and nutritional parameters. …
NAID 130000079725

Related Pictures

★リンクテーブル★

リンク元	「低トリヨードサイロニン症候群」
関連記事	「sick」「euthyroid」「syndrome」

「低トリヨードサイロニン症候群」

Euthyroid sick syndrome
Classification and external resources
Specialty	endocrinology
ICD-10	E07.8
ICD-9-CM	790.94
eMedicine	med/753
MeSH	D005067
	[edit on Wikidata]

　　[★]

英: low T₃ syndrome, low triiodothyronine syndrome
同: 低T₃症候群、甲状腺機能正常症候群ユーサイロイドシック症候群 euthyroid sick syndrome sick euthyroid syndrome、非甲状腺疾患 nonthyroidal illness
関: 甲状腺、甲状腺ホルモン、ユーサイロイドシック症候群

[show details]

甲状腺機能正常症候群 : 19 件
低トリヨードサイロニン症候群 : 12 件

概念

甲状腺が異常がないにもかかわらず、サイロキシン(T3)の濃度が低下する病態。

本症候群が見られやすい病態

OLM.296

本疾患が見られる病態：低栄養状態、重症疾患罹患時(外傷、感染症、手術)、腎不全、肝不全、心不全、悪性腫瘍
意義：T4からrT3に変換させて、エネルギーを低減させる適応減少。重症化によりT4,TSHも低下。

YN.D-167

摂取カロリー低下状態(飢餓、神経性食思不振症)、手術後、熱性疾患、肝硬変、腎不全、薬剤投与(グルココルチコイド、β受容体遮断薬)
末梢でのエネルギーを節約しようとしている病態？と考えられているらしい (YN.D-167)

検査

T4：正常
T3：低値
reverse T3：高値
FSH：正常 or やや上昇

「sick」

　　[★]

病気の

関: ail、ailment、disease、ill、illness、sickness

「euthyroid」

　　[★]

adj.

甲状腺機能正常性の

関: 甲状腺、hypothyroid、hyperthyroid

「syndrome」

　　[★]

n.

症候群

[urlEuthyroid_Sick_Syndrome:_Thyroid_Disorders:_Merck_Manual_Professional-1] "Euthyroid Sick Syndrome: Thyroid Disorders: Merck Manual Professional". Retrieved 2009-03-29.

[Liu_2013-2] Liu, S; Ren, J; Zhao, Y; Han, G; Hong, Z; Yan, D; Chen, J; Gu, G; Wang, G; Wang, X; Fan, C; Li, J (February 2013). "Nonthyroidal illness syndrome: is it far away from Crohn's disease?". Journal of Clinical Gastroenterology 47 (2): 153–9. doi:10.1097/MCG.0b013e318254ea8a. PMID 22874844.

[3] Hoermann, R; Midgley, JE; Larisch, R; Dietrich, JW (2015). "Homeostatic Control of the Thyroid-Pituitary Axis: Perspectives for Diagnosis and Treatment.". Frontiers in Endocrinology 6: 177. doi:10.3389/fendo.2015.00177. PMID 26635726.

[Rosolowska-Huszcz2005-4] Rosolowska-Huszcz D, Kozlowska L, Rydzewski A (August 2005). "Influence of low protein diet on nonthyroidal illness syndrome in chronic renal failure". Endocrine 27 (3): 283–8. doi:10.1385/ENDO:27:3:283. PMID 16230785.

[5] Han G, Ren J, Liu S, Gu G, Ren H, Yan D, Chen J, Wang G, Zhou B, Wu X, Yuan Y, Li J. Nonthyroidal illness syndrome in enterocutaneous fistulas. Am J Surg. 2013 Sep;206(3):386-92 doi:10.1016/j.amjsurg.2012.12.011. PMID 23809674.

[dietrich2015-6] Dietrich, JW; Müller, P; Schiedat, F; Schlömicher, M; Strauch, J; Chatzitomaris, A; Klein, HH; Mügge, A; Köhrle, J; Rijntjes, E; Lehmphul, I (2015). "Nonthyroidal Illness Syndrome in Cardiac Illness Involves Elevated Concentrations of 3,5-Diiodothyronine and Correlates with Atrial Remodeling". European Thyroid Journal 4: 129–37. doi:10.1159/000381543. PMC 4521060. PMID 26279999.

[7] Pinna G, Meinhold H, Hiedra L, Thoma R, Hoell T, Gräf KJ, Stoltenburg-Didinger G, Eravci M, Prengel H, Brödel O, Finke R, Baumgartner A. Elevated 3,5-diiodothyronine concentrations in the sera of patients with nonthyroidal illnesses and brain tumors. J Clin Endocrinol Metab. 1997 May;82(5):1535-42. PMID 9141546.

[8] Dietrich, JW; Stachon, A; Antic, B; Klein, HH; Hering, S (2008). "The AQUA-FONTIS study: protocol of a multidisciplinary, cross-sectional and prospective longitudinal study for developing standardized diagnostics and classification of non-thyroidal illness syndrome". BMC endocrine disorders 8: 13. doi:10.1186/1472-6823-8-13. PMC 2576461. PMID 18851740.

匿名

検索

案内

案内

sick euthyroid syndrome