An 80-year-old man is brought to the ER due to confusion. He has a one week history of cough with purulent sputm production. A chest x-ray reveals right lower lobe pneumonia, and treatment is started with supplemental oxygen and antibiotics. While hospitalized, the patient develops persistent sinus tachycardia. the Lab tests show normal TSH with low total T3 Which of the following is the primary contributor to the decreased total T3 level in this patient?

Question

An 80-year-old man is brought to the ER due to confusion. He has a one week history of cough with purulent sputm production. A chest x-ray reveals right lower lobe pneumonia, and treatment is started with supplemental oxygen and antibiotics. While hospitalized, the patient develops persistent sinus tachycardia. the Lab tests show normal TSH with low total T3 Which of the following is the primary contributor to the decreased total T3 level in this patient?

Quizplus · Accepted Answer

Eductional Objective: Euthyroid sick syndrome (ESS) is a common pattern of thyroid function markers seen in severely ill patients.  It is characterized by decreased conversion of T4 to T3 in peripheral tissues.  Initial findings include a low T3 level, but later, T4 and thyroid-stimulating hormone levels may also decrease.  ESS may represent a mild central hypothyroid state, which functions to minimize catabolism in severe illness.

An 80-Year-Old Man Is Brought to the ER Due to Confusion