Serum thyroid hormone levels in patients with fulminant hepatitis: Usefulness of rT3 and the rT3/T3 ratio as prognostic indices
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To evaluate thyroid function in 19 patients with fulminant hepatitis (FH), we have measured total and free 3,5,3′-triiodothyronine (T3) and thyroxine (T4), 3,3′,5′-triiodothyronine (reverse T3, rT3), thyroidstimulating hormone (TSH) and thyroxin-binding globulin (TBG) in patients with FH, compared with those of 80 patients with other various liver diseases and of 10 healthy controls. Patients with FH showed the lowest values of serum T3 and the highest levels of rT3 among all patients with liver diseases studied. Furthermore, patients with FH showed a significant increase of rT3 in comparison with subacute hepatitis (SAH), “acute-on-chronic” (AOC) type of hepatic failure, ordinary and severe forms of acute hepatitis (AHo and AHs) and decompensated liver cirrhosis (LC-D). In addition, serum T3 and rT3 and the rT3/T3 ratio significantly correlated with prothrombin time (PT) and plasma methionine level. We also found that serum T3 and rT3 concentrations and the rT3/T3 ratio showed early and rapid normalization in cases of FH that survived, but they did not improve in patients with fatal outcome. These results suggest that serum T3, particularly rT3 concentrations and the rT3/T3 ratio may be useful indicators for assessing the severity and prognosis of patients with FH and can be considered to the sensitive indices for functioning hepatic microsomal reserve as well.
Key WordsFulminant hepatitis Hepatic microrosomal function T3 T4 rT3
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- 4).L’age M, et al: Relations between serum levels of TSH, TBG, T4, T3, rT3 and various histologically classified chronic liver diseases. J Endocrinol Invest 1980, 4: 379Google Scholar
- 6).Kabada UM, et al: Serum T3 and reverse T3 levels in hepatic cirrhosis: Relation to hepatocellular damage and normalization on improvement in liver dysfunction. Am J Gastroenterol 1983, 78: 750Google Scholar
- 10).Hoffken B, et al: Regulation of thyroid hormone metabolism in rat liver fraction. Biochim Biophys Acta 1976, 539: 114Google Scholar
- 11).Kaplan MM, et al: Iodothyronine metabolism in rat liver homogenates. J Clin Invest 1978, 61: 456Google Scholar
- 12).Israel Y, et al: Thyroid hormones in alcoholic liver disease. Effect of treatment with 6-n-propylthiouracil. Gastroenterology 1976, 76: 116Google Scholar
- 14).Association of Inuyama Symposium Publication: The criteria of fulminant hepatitis in Literature of the 12th Inuyama Symposium. Chugai Medical Publications, Tokyo, 1982, 110 (Jpn)Google Scholar
- 15).Sherlock DS: Acute (Fulminant) hepatic failure, in Diseases of the Liver and Biliary System 6th ed. Blackwell Scientific Publications, 1981, 107Google Scholar
- 16).Tomita E, et al: Clinical evaluation of plasma free methionine concentration and prothrombin time for differential diagnosis of fulminant hepatitis. Jpn J Gastroenterol 1982, 79: 104 (Jpn)Google Scholar
- 18).Chopra IJ, et al: Evidence for an inhibitor of extrathyroidal conversion of thyroxin to 3,5,3′-triiodothyronine in sera of patients with nonthyroidal illnesses. J Clin Endocrinol Metabol 1985, 60: 666Google Scholar
- 20).Chopra IJ, et al: In search of an inhibitor of thyroid hormone binding to serum proteins in nonthyroidal illness. J Clin Endocrinol Metabol 1979, 49: 63Google Scholar