THYROID HORMONE ABNORMALITY IN PATIENTS WITH ACUTE STROKE- A HOSPITAL BASED CASE CONTROL STUDY

Introduction: Stroke or Cerebrovascular accident (CVA) is a major cause of disability worldwide. The estimation of serum Total T3, Total T4 and TSH are very much essential in patients with stroke. Any disturbances in thyroid hormones may have negative influence on the outcome of acute phase of strokes.

Aims And Objectives: Aims and objective was to estimate the Total T3, Total T4 and TSH of patients with acute Stroke and to compare it with age/sex matched healthy controls.

Materials & Methods: This Hospital Based Case Control Study, consist of total 100 subjects out of which 50 were control ,was carried out in Jorhat Medical College & Hospital, Assam for a period of one year, from July 2017 to June 2018. Age more than 40 years of both sexes was included. Estimation for total T3, total T4, and TSH was carried out in Access 2 ImmunoAssay Systems (Beckman Coulter). Cases were selected  randomly .

Results And Observations: Out of 50 Stroke patients ,the age group of 50 - <60 years constituted the majority of cases(32%) . Greater preponderance of stroke was seen in males (62%) with male to female ratio of 1.63:1. Hemorrhagic stroke was found to be more common than ischemic stroke (54% V/s 46%). Hemorrhagic strokes occurred more in early age than ischemic strokes. The mean ± SD of serum Total T3 levels in stroke patients and controls were 0.960 ± 0.327 and 1.248 ± 0.269 respectively, with statistically significant mean value difference (p<0.05) when cases were compared to the controls. A greater number of low T3 was present in ischemic strokes (43.5%) when compared to hemorrhagic strokes (18.5%).

Conclusion: Nonthyroidal illness syndrome (Low T3 syndrome) is observed in the present study with decreased T3 values without alteration of T4 and TSH levels. Further studies with a large sample size should attempt to investigate whether treatment of low T3 syndrome can improve the final outcome.