Abstract

Objective: Sick euthyroid syndrome (SES) is defined as abnormal thyroid hormone levels without any thyroid diseasei which is seen during the progression of chronic or severe diseases. The common feature of this disorder is a low level of free triiodothyronine (fT3), with generally normal blood free thyroxine (fT4) levels and either normal or slightly suppressed thyroidstimulating hormone (TSH).

Material and Method: We examined the incidence of SES in COPD patients either in a stable state or acute exacerbation. 45 cases, who had previously been diagnosed as COPD in our clinic, with severe or modarate disease, were included in the study. Cases were grouped according to the state of the disease; stable or in acute exacerbation. fT3, fT4, TSH levels and spirometry values in all cases and arterial blood gas analyses in cases with acute exacerbation were recorded.

Results: Of the 45 cases with COPD (M/F:43/2) aged between 43 to 80 (61.6±9.9) years, 25 were in stable state and 20 cases were in acute exacerbation. Thyroid hormone levels in cases with acute exacerbation were fT3: 2.32±0.53 pg/ml, fT4:1.17±1.14 ng/dl, TSH:0.69±0.59, where the levels were fT3: 2.99±0.43 pg/ml, fT4: 0.79±0.11 ng/dl, TSH: 1.22±0.77 in stable cases. The fT3 level in the group with acute exacerbation was significantly lower than the cases in the stable state (p<0.001). SES was seen in 70% (14/20) percent of cases with acute exacerbation and 8% (2/25) of cases in the stable state.

Conclusion: In conclusion, we determined that SES is significantly higher in acute than stabile cases in COPD (p<0.001). (Tur Toraks Der 2011; 12: 1-4)