What is the role of hepatitis in the development of euthyroid sick syndrome?

Updated: Aug 28, 2020
  • Author: Serhat Aytug, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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In infectious hepatitis, the abnormalities are not the common ones. Total T4 often is unchanged. Total T4 is elevated when TBG is increased. Free T4 may be reduced, total T3 is increased, free T3 is decreased, rT3 is unchanged, and basal TSH is increased. TSH response to TRH is exaggerated.

Chronic active hepatitis and primary biliary cirrhosis

In these cases, serum levels of TBG are increased, resulting in increased levels of total T4 and T3 and decreased T3 resin uptake. In contrast to patients with cirrhosis, decreased free T4 and free T3 levels, elevated basal TSH, and unchanged rT3 levels are present. TSH response to TRH stimulation is exaggerated.

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