Changes in thyroid hormones in patients with chronic acalculous cholecystitis in the practice of a family doctor

К.в Вовк ,O G Reznichenko ,О Н Власенко ,S V Gridnieva ,Hanna Kratenko

doi:10.26565/2313-6693-2020-40-13

Abstract

Abstract. Among biliary pathology, chronic acalculous cholecystitis (CAC) occupies one of the central places. The important role of the hormonal system in the regulation of the functioning of the biliary tract has been known for a long time, but the specific mechanisms of these influences remained unclear. Based on the results of a comprehensive clinical, laboratory, biochemical and instrumental examination, all patients with chronic acalculous cholecystitis were divided into three groups depending on the variant of impairment of the motor-kinetic function of the gallbladder. The first group consisted of patients with CAC and hypertensive-hyperkinetic gallbladder dyskinesia (group I) – 17 people; the second – patients with CAC with mixed hypotonic-hyperkinetic gallbladder dyskinesia (group II) – 19 people; the third – patients with САС and hypotonic-hypokinetic dyskinesia of gallbladder (III group) – 29 people. The level of free FT3, FT4, and thyroid-stimulating hormone (TSH) was determined by the immunofluorescence method using BREAHMS test systems (Henning Berlin GMBH). The disproportion between the thyroid hormones and the quantitative predominance of the inactive form made it possible to identify the relative hypothyroid syndrome in group I patients. The disproportion between the biologically inactive and active forms of thyroid hormones with a quantitative predominance of the inactive form made it possible to judge the presence of a relative hypothyroid syndrome in group II patients. In group III patients, a significantly increased TSH level was revealed, which was a response of the hypothalamic-pituitary system to a decrease in the level of FT3.

Highlights

In everyday practice, doctors of different specialties have to deal with diseases of the biliary tract: gastroenterologists, therapists, surgeons, emergency and emergency doctors
The simplicity of measurement has been converted to simplicity of interpretation, ignoring the fact that thyroid-stimulating hormone (TSH) is both an indirect measure of thyroid hormone homeostasis and a control element
The purpose of the work is the study of thyroid hormones in patients with chronic acalculous cholecystitis (CAC) depending on dyskinetic disorders

Summary

INTRODUCTION

Doctors of different specialties have to deal with diseases of the biliary tract: gastroenterologists, therapists, surgeons, emergency and emergency doctors. The simplicity of measurement has been converted to simplicity of interpretation, ignoring the fact that TSH is both an indirect measure of thyroid hormone homeostasis and a control element. While recognizing the strategic benefits of TSH measurement, such as ease of use, suitability for first-line screening, detection of minor functional abnormalities, and association with various health outcomes, including mortality, there are significant risks of misrepresenting its complex physiological importance. This is supported by the ongoing discussion around the TSH reference limits, especially its upper limit, which determines subclinical hypothyroidism [12]. This applies to patients with subclinical dysfunction, in which the relationship between FT4 and TSH shows both elements of normality and abnormalities [15]

OBJECTIVE

MATERIALS AND METHODS

CONCLUSIONS