Changes of thyroid function may occur after short loss of consciousness, but they haven't been systematically evaluated up to now, although occasional observations suggest temporal increases in TSH concentration. This study aims at assessing transient changes of biomarkers of thyroid function after syncopation and seizure. Results of the study might contribute to an improved detection rate of thyrotoxicosis.
Transient allostatic responses of thyroid function have been described in critical illness. Own observations suggest similar reactive responses after syncopation and cerebral seizures. They are marked especially by increased concentration of serum thyrotropin (TSH), suggesting a type 2 allostatic response. However, changes of thyroid function after temporal loss of consciousness haven't been systematically evaluated up to now. Current diagnostic guidelines recommend primarily the determination of serum TSH concentration for screening of thyroid function, and the measurement of peripheral thyroid hormones (T4 and/or T3) is only recommended if TSH determination results in pathological values. This TSH reflex strategy may be misleading after short-term loss of consciousness. This study aims at assessing the prevalence of allostatic responses of thyroid function after events of syncopation or seizure and at investigating the consecutive temporal development of biomarkers of thyroid function. An additional aim includes the diagnostic value of TSH determination, compared to measurement of free thyroid hormones, for thyroid dysfunction after syncopation or seizure. Results of this study might contribute to an improved detection rate of thyrotoxicosis. In cases of medical emergencies and in-patient treatment interventions with a significant iodine load are common, including the application of iodinated radiocontrast agents and amiodarone. In this setting, undetected hyperthyroidism may lead to thyroid storm, which is associated with a high mortality.
Study Type
OBSERVATIONAL
Enrollment
350
Determination of TSH, free T4, free T3, SPINA-GT, SPINA-GD and Jostel's TSH index
Institute of Clinical Chemistry, Transfusion and Laboratory Medicine, Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum
Bochum, North Rhine-Westphalia, Germany
ACTIVE_NOT_RECRUITINGMedical Hospital I, Bergmannsheil University Hospitals, Ruhr University of Bochum
Bochum, North Rhine-Westphalia, Germany
RECRUITINGMedical Hospital II, Bergmannsheil University Hospitals, Ruhr University of Bochum
Bochum, North Rhine-Westphalia, Germany
Prevalence of allostatic responses of thyroid function after short-term loss of consciousness
Prevalence of increased TSH immediately after syncope or seizure
Time frame: 2 hours
Time series of thyroid function after short-term loss of consciousness
Temporal evolution of TSH and thyroid hormone concentration during three days after syncope or seicure
Time frame: 72 hours
Diagnostic value of TSH after short-term loss of consciousness
Sensitivity, specificitay and likelihood ratios of TSH compared to free T4 and free T3 after syncopation or seizure
Time frame: 72 hours
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Neurological University Hospital and Clinics, Bergmannsheil University Hospitals, Ruhr University of Bochum
Bochum, North Rhine-Westphalia, Germany
RECRUITING