Hypothalamo-hypophyseal-thyroid changes in alcoholic hepatic cirrhosis
Zamora Madaria, E.; Mangas Rojas, A.; Barba Chacón, A.; Feliu Zamora, C.; Gómez Rodríguez, F.
Medicina Clinica 83(16): 660-664
1984
ISSN/ISBN: 0025-7753 PMID: 6439960 Document Number: 238313
To demonstrate the role of the severity of hepatic function impairment in the development of the syndrome of low T3 , T3, reverse T3 (rT3), and thyroxine binding globulin (TBG) were determined and correlated them with Orrego's biological clinical index. The effect that these thyroidal hormones abnormalities have on the metabolic status of these patients was investigated. Decompensated cirrhotic patients had decreased circulating values of T3 and an augmentation of rT3. These abnormalities were not accompanied by changes in the serum concentration of T4 nor with changes of the free thyroxine index, except some cases with a marked decompensation who had a slight decrease of T4 secondary to the diminished synthesis of TBG. The abnormalities depended on the degree of impairment of the hepatic function, since there was a significant correlation between the biological clinical index and the T3 and rT3 abnormalities, which were valuable parameters for determining the evolution and prognosis of the disease. The metabolic status of all patients evaluated by studying the reflexogram and the baseline levels of thyrotropin (TSH) and its response to thyrotropin releasing hormone (TRH) test were considered normal. Abnormalities in the response of TSH was seen in patients with NH4 encephalopathy due to hypothalamic disturbances secondary to the depletion in the cerebral neurotransmitters produced by the encephalopathy.