Thyroid hormone profile and PELOD score in children with sepsis

  • Agung G. Tanurahardja Child Health Department, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital
  • Antonius H. Pudjiadi Child Health Department, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital
  • Pramita G. Dwipoerwantoro Child Health Department, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital
  • Aman Pulungan Child Health Department, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital
Keywords: euthyroid sick syndrome, nonthyroidal illness, sepsis, procalcitonin, thyroid, PELOD, PICU


Background Thyroid hormonal dysfunction, also known as
euthyroid sick syndrome or nonthyroidal illness, can be seen
in sepsis. There have been few studies on thyroid hormone
dysfunction in septic children, as well as on a relationship
between their thyroid hormone profiles and pediatric logistic
organ dysfunction (PELOD) scores. Procakitonin (PCT) is one
of the sepsis biomarker.
Objective To evaluate the thyroid hormone profile in children
with sepsis as well as to assess for a correlation between the thyroid
levels and PELOD scores, PCT levels, and patient outcomes.
Methods This cross-sectional study included children aged 1- 18
years admitted to the pediatric intensive care unit (PICU) with a
primary diagnosis of sepsis. PELOD scores and thyroid hormonal
levels were assessed once during the first 24 hours after PICU
Results Thirty subjects were included in the study. The median
values ofT3, free T4, and TSH were 45 (range 17 -133) ng/dL,
0.81 (range 0.3-1.57) ng/dL, and 1.36 (range 0.05-7.78) ╬╝IU/L,
respectively. The T3, free T4, and TSH levels were decreased in
97%, 50% and 40% of the subjects. There were no significant
differences between low and normal to high TSH with regards to
the PELOD score (P=0.218), PCT level (P=0.694), or patient
outcomes (P=0.55). The risk of death increased by 15 times
among the subjects with PELOD score ~20 compared to those
with PELOD score <20 (OR 15; 95%CI: 1.535 to 146.545;
Conclusion Thyroid hormones are decreased in septic children
with the majority having low T3. A high PELOD score is strongly
correlated with mortality and can be used as a prognostic parameter
for septic children in the PICU, but there is no correlation with
decreased TSH.


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How to Cite
Tanurahardja A, Pudjiadi A, Dwipoerwantoro P, Pulungan A. Thyroid hormone profile and PELOD score in children with sepsis. PI [Internet]. 31Aug.2014 [cited 20Jan.2022];54(4):245-0. Available from:
Received 2016-09-20
Accepted 2016-09-20
Published 2014-08-31