Abstract

IntroductionChanges in thyroid hormone levels, mostly as non-thyroidal illness syndrome (NTIS), have been described in many diseases. However, the relationship between acute liver failure (ALF) and thyroid hormone levels has not yet been clarified. The present study evaluates potential correlations of select thyroid functional parameters with ALF.Methods84 consecutively recruited ALF patients were grouped according to the outcome of ALF (spontaneous recovery: SR; transplantation or death: NSR). TSH, free thyroxine (fT4), free triiodothyronine (fT3), T4, and T3 were determined.ResultsMore than 50% of patients with ALF presented with abnormal thyroid parameters. These patients had greater risk for an adverse outcome than euthyroid patients. SR patients had significantly higher TSH, T4, and T3 concentrations than NSR patients. Albumin concentrations were significantly higher in SR than in NSR. In vitro T3 treatment was not able to rescue primary human hepatocytes from acetaminophen induced changes in mRNA expression.ConclusionsIn patients with ALF, TSH and total thyroid hormone levels differed significantly between SR patients and NSR patients. This might be related to diminished liver-derived transport proteins, such as albumin, in more severe forms of ALF. Thyroid parameters may serve as additional indicators of ALF severity.

Highlights

  • Changes in thyroid hormone levels, mostly as non-thyroidal illness syndrome (NTIS), have been described in many diseases

  • Changes in thyroid-stimulating hormone (TSH) and thyroid hormone levels are often present in patients with severe diseases

  • Such changes are seen as a consequence of the illness and are called ‘non-thyroidal illness syndrome’ (NTIS) and have been described in many diseases including myocardial infarction, heart failure or sepsis [1,2,3]

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Summary

Objectives

We aimed to mimic the condition of acute liver failure by treating primary human hepatocytes with T3 in parallel to toxic or apoptotic injury

Methods
Discussion
Conclusion

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