Diagnostic value of thyroid function tests in the euthyroid sick syndrome

ABSTRACT

We studied thyroid function tests in a group of non thyroidal illnesses "Euthyroid Sick Syndrome ESS" to find any possible alterations as well as the test most reliable in unraveling the actual state of thyroid function under such conditions. Serum T4, T3, FT4I, FT3I and TSH uere measured in patients with insulin dependent diabetes IDD [10 and 11], chronic renal failure CFR [10 and 9], hematologic malignancy [12 and 15] in an Egyptian and American sample respectively. Seventeen Egyptian patients with hepatosplenic schistosomiasis [HSS] and 17 American patients withacute psychiatric illnesses were also studied. There was a tendency for T3 to decrease in all groups of study and T4 to increase in the group uith acute psychiatric illnesses. TSH used to be the most useful test in all groups of study to diagnose euthroidism. It is to be concluded that thyroid function test my be altered in non thyroidal illnesses. These changes however seem to be minimal and correlate with severity of the underlying illness. TSH is the least likely to change and is the best diagnostic test which reflects the actual euthyroid state in such cases