Thyroid status in nonthyroidal illness (NTI): hamatologic malignancies

Hippokratia 1998, 2(4):174-178

R. Tsitamidou, Z. Foka, N. Ignatova, N. Tourlas, T Giti


Abstract

Patients with nonthyroidal illness (NTI) but without any apparent underlying thyroid disease often display abnormal values of thyroid hormones. These alterations include low, normal or increased serum T4, reduced T3, normal or low TSH levels. The NTI may affect the hypothala-mus-pituitary-thyroid axis. Evaluation is further complicated by changes in nutrition and effects of medication. The aim of the study was to investigate the prevalence of abnormalities in thyroid assessment tests in patients suffering from hematologic malignancies.The patients (59) were divided according to their therapy (first diagnosis, marrow transplantation, conventional chemotherapy-therapy with interleukin-2 and with GVHD). Serum T3, FT4 and TSH (chemiluninescence method) were assayed. 31% of patients showed biochemical signs of thyroid dysfunction and the remaining pts were euthyroid. These abnormalities will be nonspecific, transient and secondary.
We present a case report of a large epidermoid cyst of the larynx which was removed with direct laryngoscopy from an adult male patient complaining of dysphagia and hoarseness without dyspnea, for an over two month period. The interest in this case is on the large size and rare location of the cyst at the supraglottic region of the larynx, thus causing dysphagia and hoarseness without dyspnea.