triiodothyronine--reverse and Burns

Burned male Syrian hamsters (burn size 23% of body surface) exhibited reduced total (T4) and free (FT4) serum concentrations, a defect in T4 binding to serum proteins manifested by the T4 dialyzable fraction but not the in vitro T3 charcoal uptake, and reduced serum testosterone concentration. These changes are similar to those noted previously in burned humans. Unlike such patients, burned hamsters did not exhibit reduced serum T3 nor elevated rT3 concentrations in a reproducible manner. Pinealectomy performed before burning in hamsters did not prevent the burn-induced depression in serum T4 and testosterone.

Topics: Animals; Blood Proteins; Burns; Cricetinae; Male; Mesocricetus; Pineal Gland; Testosterone; Thyroid Hormones; Thyroxine; Triiodothyronine, Reverse

The correlation between protein turnover and serum thyroid hormone levels was studied in 10 children, ages 1 to 16 years subsequent to severe burn injuries. In contrast to published studies that have shown depression of triiodothyronine (T3) and elevations of reverse T3 (rT3) in stressed patients, no change was found in the mean level of T3 and a 69% decrease in rT3 compared to healthy controls of similar age. Whole body rates of protein synthesis and breakdown were determined using a [15N]glycine turnover technique. The difference between synthesis and breakdown was negatively correlated with the ratio, rT3/T3 in serum. Thus, in burned children, a decrease in N balance was associated with a rise in rT3/T3 which is qualitatively similar to that observed in fasted individuals or in stressed patients who may be semistarved.

Topics: Adolescent; Burns; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Female; Humans; Infant; Male; Nitrogen; Nutritional Physiological Phenomena; Protein Biosynthesis; Proteins; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

A prospective study of thyroid function was performed in 25 thermally injured patients. These patients are divided into two groups. The first group contains five patients with greater than 50% burn size studied longitudinally during the first 15 days following thermal injury. Significant suppression of serum concentrations of 3,5,3'-triiodothyronine (T3) and elevation of serum concentrations of 3,3',5'-triiodothyronine (rT3) were seen. The free thyroxine index and serum TSH concentrations remained within the normal range. To assess the clinical significance of these alterations in peripheral thyroid hormone concentrations, a second group of 20 patients was studied. We measured the free serum levels of T4 (FT4) and T3 (FT3) in ten patients, mean age 34 years, mean burn size 56%, studied during a period of clinical deterioration, and in ten patients of comparable age and burn size who were clinically stable. Both FT4 and T3 values were significantly lower in the unstable patients (p < 0.01). All FT3 values for the unstable patients (M +/- SE), 193 +/- 14 pg/dl, were below the normal range for FT3 of 230 to 669 pg/dl, and significantly lower than those observed in the stable patients (M +/- SE), 430 +/- 59 pg/dl (p < 0.001). This correlation of biochemical hypothyrodisim with clinical deterioration may have functional significance for the critically ill trauma patient.

Topics: Adolescent; Adult; Burns; Energy Intake; Humans; Male; Middle Aged; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse