[Thyroid function tests in viral chronic hepatitis].
BACKGROUND
One hundred and twenty five patients with virus B or C chronic active hepatitis and postnecrotic cirrhosis and different degrees of liver dysfunction were studied.


OBJECTIVE
1) To determine a thyroid hormonal profile; 2) to evaluate the prognostic value of these tests in relation to the progression of the disease and mortality; 3) compare these findings with Child-Pugh classification.


METHODS
The patients were divided in four groups: a) 31 with chronic active hepatitis; b) 41 with postnecrotic cirrhosis Child A; c) 35 with postnecrotic cirrhosis Child B and d) 18 with postnecrotic cirrhosis Child C. The protocol comprised serum measurements of albumin and bilirrubin, estimates of prothrombin time and clinical evaluation of ascites and encephalopathy, measurement of total serum triiodothyronine, thyroxine, thyroid-stimulating hormone, free thyroxine, reverse triiosothyronine, calculated rT3/T3 index (IrT3) and thyrotropin-releasing hormone test.


RESULTS
Total serum triiodothyromnine showed the most significant difference among the groups, gradually lower as the disease became more advanced (CAH: 149.2 +/- 42.3 ng/dL; PNC-A: 137.4 +/- 37.2 ng/dL; PNC-B: 88.0 +/- 28.4 ng/dL and PNC-C: 41.8 +/- 21.9 ng/dL). Low levels of T4 (4.5 +/- 2.0 micrograms/dL) and FT4 (0.7 +/- 0.4 ng/dL) and elevated levels of thyroid-stimulating hormone (7.2 +/- 11.5 microIU/mL), reverse triiosothyronine (60.8 +/- 52.1 ng/dL) and calculated rT3/T3 index (2.2 +/- 2.6) were more frequent in patients with postnecrotic cirrhosis Child C. Thyrotropin-releasing hormone test was normal in the majority of the patients.


CONCLUSIONS
The present study shows a positive relationship between the low serum levels of T3 and elevated serum levels of rT3 and IrT3/T3 with the degree of hepatic dysfunction according to the Child-Pugh classification.
Novis
M
M
Serviço de Gastroenterologia, Hospital Universitário Clementino Fraga Filho, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, FM-UFRJ.
Vaisman
M
M
Coelho
H S
HS
D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone / Q000097:blood
D013963:Thyroid Hormones; D013973:Thyrotropin-Releasing Hormone; D013972:Thyrotropin
Teste da função tiroidiana na hepatite crônica viral.