Thyroid Hormones in Burn Injured Children

Barclay, C.; Sedowofia, Kofi; Thomson, Margaret; McIntosh, N

doi:10.1042/bst024271s

Cited by 3 publications

(4 citation statements)

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“…The fasting glucose was normal in all cases on the third month (90.82 +/-10. 33) Insulin and fasting blood glucose levels changed significantly with time and also fasting blood glucose levels increased with higher TBSA burned. In addition insulin and fasting blood glucose levels were correlated.…”

Section: Resultsmentioning

confidence: 97%

“…These few studies report that thyroid hormones are low following burn injury, as in adults 32,33 . Thyroid hormones are reported to fall, especially in major burns, possibly due to the body's metabolic adaptation 34 .…”

Section: Discussionmentioning

confidence: 92%

“…T3 and T4 and free hormone levels are suppressed in pediatric burns as in adult burns 6 . The complexity of the hormonal changes is only now being clearly understood in adults, but data on the changes which accompany such injury in children are limited.…”

Section: Introductionmentioning

confidence: 98%

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The Evaluation of the Adrenal and Thyroid Axes and Glucose Metabolism after Burn Injury in Children

Şenel¹,

Kızılgün²,

Akbiyik³

et al. 2010

Journal of Pediatric Endocrinology and Metabolism

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Introduction: Burn injury is an important trauma and can cause many hormonal and metabolic changes in the human body. In contrast to the situation with adults, there are inadequate number of studies on children with this condition. Our aim in this study was to determine the changes in the adrenal, thyroid axes and glucose metabolism in the acute and subacute period and relation to the percent total body surface area (TBSA) burned in children with major burn injury. Patients and Method: A total of 90 hospitalized children aged 0-13 years (mean: 3.44±2.90 years) with major fluid burn injury were included in this study. Serum ACTH, cortisol, fasting glucose and insulin and thyroid hormones (free T3 and T4, TSH) were evaluated in the first 24 hours after the burn injury and on day 3 and month 3 consequently in all of the cases. An ACTH stimulation test was performed when necessary. Continuous variables were compared with analysis of variance and categorical variables were compared with the chi-square test. The Pearson correlation was used to determine the relation between ACTH and cortisol and between blood glucose and insulin (on day 1 and 3 and month 3). Also the correlation with the TBSA burned and the hormonal values were evaluated. A p value <0.05 was considered statistically significant. Findings: ACTH and Cortisol level increased in first 24 hours and decreased significantly by time. The change of ACTH and Cortisol level with time was significantly related to the

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Section: Resultsmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 92%

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The Evaluation of the Adrenal and Thyroid Axes and Glucose Metabolism after Burn Injury in Children

Şenel¹,

Kızılgün²,

Akbiyik³

et al. 2010

Journal of Pediatric Endocrinology and Metabolism

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“…T3 and T4 and the free hormone levels are suppressed in pediatric burns as in adult burns (14); however, the effect of rhGH on serum thyroid hormone has not been established.…”

Section: Introductionmentioning

confidence: 97%

Recombinant Human Growth Hormone Increases Thyroid Hormone-Binding Sites in Recovering Severely Burned Children

Connolly

Barrow

Chinkes

et al. 2003

Shock

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Thyroxine (T4), Tri-iodothyronine (T3), and total serum protein levels are reduced in severely burned children. T4 and T3 are carried on serum transport proteins via thyroid hormone-binding sites (THBS). Treatment of bums with recombinant human growth hormone (rhGH) increases albumin (Alb) and prealbumin (PreAlb), which bind nearly 30% of circulating T4 and T3. This study investigated the effect of rhGH on THBS sites in burned children. Records of 11 acutely burned children with a total body surface area burned >40% who were randomized to either a daily subcutaneous injection of rhGH at 0.05 mg/kg/day or placebo for 6 months after discharge from hospital were reviewed. Thyroxine uptake percentage (TU%), Total T4 levels (TT4), free thyroxine index, Alb and PreAlb, and height and weight measurements taken at discharge and 6 months later were compared in both groups. In the six children who received rhGH, mean TU% had decreased from 41 +/- 1 to 33 +/- 1% by 6 months postdischarge, (P < 0.001), mean TT4 increased from 5.8 +/- 0.3 to 8.1 +/- 0.8 microg/dL, (P < 0.02), mean Alb increased from 2.0 +/- (0.6) to 3.5 +/- (0.1) g/dL (P < 0.0001), and mean PreAlb increased from 8.7 +/- 0.7 to 16.5 +/- 2.1 mg/dL, (P < 0.006). There were no significant changes in the five children in the placebo (control group), and height and weight did not significantly change in either group. rhGH significantly increases THBS in severely burned children, possibly through increases in serum Alb and PreAlb. The increases in circulating thyroxine observed in this group may be involved in the attenuation of growth arrest.

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