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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/15975
Title: The pituitary-thyroid axis in severe falciparum malaria: Evidence for depressed thyrotroph and thyroid gland function
Authors: Timothy M.E. Davis
Wichai Supanaranond
Sasithon Pukrittayakamee
Sanjeev Krishna
R. Hart Gillian
Jacky M. Burrin
Somchai Looareesuwan
Nitatt Vilaiwanna
Nicholas J. white
Mahidol University
John Radcliffe Hospital
Hammersmith Hospital
Paholpolpayuhasena Hospital
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1990
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.84, No.3 (1990), 330-335
Abstract: Abnormal thyroid function is strongly associated with mortality in severe non-thyroidal illness. We have assessed the pituitary-thyroid axis serially in 18 Thai adults with severe falciparum malaria and in 18 matched controls. The admission total serum thyroxine (T4) concentrations of the patients (median [range]: 64 nmol/litre [ < 30-91]) were significantly lower than those of controls (81 nmol/litre [61-133] ; 2P < 0·01), and remained depressed until alter fever and parasite clearance. Two patients who died in hospital had admission serum T4 concentrations < 35 nmol/litre. The admission basal serum thyrotropin (TSH) levels of the patients (0·9 mU/litre [ < 0·2-3·1]) were similar to those of controls (1·3 mU/litre [ < 0·2-3·7], 2P > 0·1) and remained normal throughout fever and parasitaemia. Thirty-minute TSH increments during a thyrotropin-releasing hormone test on admission were reduced in 13 patients with severe malaria (4·1 mU/litre [0·7-8·1]) relative to those in convalescence (7·1 mU/litre [1·7-14·4] , n = 10, 2P < 0·01) and controls (5·6 mU/litre [3·3-12·9], n = 9, 2P < 0·05). These findings suggest that thyrotroph and thyroid gland function are depressed during acute, severe malaria. As these changes may be an adaptation to accelerated catabolism, the role of thyroid replacement in such patients is uncertain. © 1990, Royal Society of Tropical Medicine and Hygiene. All rights reserved.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0025324559&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/15975
ISSN: 18783503
00359203
Appears in Collections:Scopus 1969-1990

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