Thyroid Hormone Dysfunction and CRP Levels in Neonates With Sepsis

Abstract

Background: Thyroid hormone abnormalities are frequently encountered in patients with critical illness. Sepsis is an important cause of death of neonates in developing countries. The aim of our study was to evaluate the prognostic role of thyroid hormones (FT3, FT4, TSH) in neonates specifically with sepsis and septic shock and to correlate their levels of C-reactive protein (CRP).

Methods: Forty neonates with sepsis were included in the study as cases. Neonates with gestational age less than 37 weeks, body weight less than 2,500 grams or with congenital abnormalities were excluded from the study. Septic neonates were further divided into sepsis survivors (n = 19), shock-survivors (n = 9) and non-survivors. Forty full term neonates without sepsis served as controls. Thyroid hormones and CRP were estimated by chemiluminescent immunometric assay and immunoturbidimetric assay respectively.

Results: The FT3 and FT4 hormones levels were significantly decreased (P < 0.001) in neonates with sepsis as compared to controls. No significant difference was observed in TSH levels. Non survivors had lower FT3 and FT4 levels (P < 0.05) compared to sepsis-survivor group. There was also a significant negative correlation between CRP and FT3 level in non-survivor group (r = -0.60; P = 0.02) and septic shock survivor group (r = -0.78; P = 0.006).

Conclusions: Low levels of FT3 and elevation in CRP correlate closely with decreased survival in septic neonates.




J Endocrinol Metab. 2013;3(3):62-66
doi: https://doi.org/10.4021/jem167w