Critically ill patients: Histopathological evidence of thyroid dysfunction.

Autor: Saha D; Nilratan Sircar Medical College and Hospital, 138 Acharya Jagadish Chandra Bose Road, Kolkata, West Bengal 700014, India. Electronic address: dipti.saha@outlook.in., Chattopadhyay S; Department of Forensic Medicine and Toxicology, Nilratan Sircar Medical College and Hospital, 138 Acharya Jagadish Chandra Bose Road, Kolkata, West Bengal 700014, India., Dutta SS; Department of Forensic Medicine and Toxicology, Nilratan Sircar Medical College and Hospital, 138 Acharya Jagadish Chandra Bose Road, Kolkata, West Bengal 700014, India., Roy AK; Department of Pathology, Nilratan Sircar Medical College and Hospital, 138 Acharya Jagadish Chandra Bose Road, Kolkata, West Bengal 700014, India.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2023 Dec; Vol. 78, pp. 154384. Date of Electronic Publication: 2023 Jul 25.
DOI: 10.1016/j.jcrc.2023.154384
Abstrakt: Purpose: Critical illness is characterized by severe biphasic physical and metabolic stress as result of systemic inflammatory response syndrome and/or multiple organ dysfunction syndrome, and is frequently associated with non-thyroidal illness. Purpose of this study is to better understand the cytomorphological basis of NTI by performing histopathological examinations of thyroid gland on autopsies of patients who died from critical illness.
Methods: Histopathological examination of thyroid gland of 58 critically ill patients was performed in our hospital. The cases included 24 cases of burn injury, 24 cases of traumatic brain injury, and 10 cases of cerebral stroke. Thyroid samples obtained during autopsy were preserved in formol saline and stained with hematoxylin and eosin. The sections were visualized under light microscopy.
Results: Out of 58 cases examined, 21 patients showed normal thyroid findings, and rest of the cases had unusual thyroid findings in the histopathological study. The principal finding was distortion of thyroid follicular architecture. Other findings include mononuclear cell infiltration, clumping of thyroglobulin, and exhaustion of thyroid follicles.
Conclusion: Critical illness produces metabolically damaging effects on thyroid gland, which functionally corresponds to a state of low T3 syndrome. These changes are more pronounced in BI and cerebral stroke than in TBI.
Competing Interests: Declaration of Competing Interest The authors have no relevant financial or proprietary interests in any material discussed in this article.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE