Cancer and deliberate hypothyroidism, anesthesia, and myxedema coma: the curse of oncologic outcomes based on hypothyroidism

[...]although the primary effect of TKIs is to decrease thyroid production of the prohormone thyroxine (T4), the hypothyroidism produced by TKIs is unique in that it is also caused by the reduced intracellular conversion of T4 to its active form, triiodothyronine (T3)1 [3,6,7]. [...]the classical de...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2013-02, Vol.25 (1), p.1-3
Main Authors: Hatch, D. Matthews, MD, MBA, Roy, Raymond C., MD, PhD
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia & Perioperative Care
Antineoplastic Agents - adverse effects
Cancer
Coma - chemically induced
Female
Hormones
Humans
Hypothyroidism
Indoles - adverse effects
Myxedema - chemically induced
Pain Medicine
Postoperative Complications - chemically induced
Pyrroles - adverse effects
Surgery
Thyroid gland
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Summary:[...]although the primary effect of TKIs is to decrease thyroid production of the prohormone thyroxine (T4), the hypothyroidism produced by TKIs is unique in that it is also caused by the reduced intracellular conversion of T4 to its active form, triiodothyronine (T3)1 [3,6,7]. [...]the classical description of the hypothalamic-pituitary-thyroid (HPT) feedback loop that we all learned in medical school needs to be updated if we are to understand why the new antineoplastic agents cause hypothyroidism and how certain physiologic stresses can trigger myxedema coma [10,11].
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2012.11.002