THYROID-AXIS ALTERATIONS IN ACUTE ORGANOPHOSPHORUS POISONING AND THEIR ASSOCIATION WITH CLINICAL OUTCOMES IN THE INTENSIVE-CARE SETTING

Organophosphates are widely used in agricultural practice. Due to its easy availability in household, the incidence of accidental, occupational or homicidal consumptions have caused a major public health burden.OP compounds irreversibly inhibit acetyl cholinesterase, precipitating a cholinergic crisis characterized by muscarinic and nicotinic features. Serum of OP patients with non-thyroidal illness inhibits the uptake of thyroxine by hepatocytes, and prevents converting of thyroxine to triiodothyronine. Circulating factors such as cytokines probably affect thyroid hormone levels. 1 Nicotinic receptors are located in the preoptic area of the hypothalamus. It is claimed that cholinergic receptors stimulate somatostatin secretion, and somatostatin suppressed TRH and TSH secretion.1Previous retrospective series have reported finding-ranging from suppressed TSH with normal free hormone levels to frank thyrotoxicosis.