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. 1975 Jan;50(1):40–44. doi: 10.1136/adc.50.1.40

Thyroid function during exchange transfusion.

R D Milner, J G Ratcliffe
PMCID: PMC1544473  PMID: 1168447

Abstract

The changes in plasma thyroid hormone concentration were studied during exchange transfusion performed for haemolytic disease. 24 transfusions were performed using blood preserved with acid-citrate and dextrose and in 11 cases 10 or 50 mug glucagon was added to the donor blood. Plasma tri-iodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroid hormone binding capacity, and free thyroxine index were measured in the donor blood and in the infant at the start and at intervals during the transfusion. Before transfusion the plasma TSH levels of the infants fell as postnatal age indreased and plasma T3 and T4 were correlated with one another. In 20 transfusions the mean infant/donor ratio of TSH was approximately 10, of T4 3, and of T3 2. During these transfusions there was a progressive fall in the infant's plasms TSH, T4, and T3 concentration. In 3 transfusions in which the donor plasma TSH was greater than that of the infant, plasma TSH levels rose during the transfusion and in 2 cases this was associated with a late rise in plasma T3 levels. The addition of glucagon to donor blood had no effect on thyroid hormone levels. It is concluded that erythroblastotic infants have normal thyroid function and that they became biochemically hypothyroid during transfusion. Acute changes in plasma thyroid hormone and glucagon concentration do not induce TSH responses by the neonatal pituitary during the period of the exchange transfusion.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abuid J., Stinson D. A., Larsen P. R. Serum triiodothyronine and thyroxine in the neonate and the acute increases in these hormones following delivery. J Clin Invest. 1973 May;52(5):1195–1199. doi: 10.1172/JCI107286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Burke G. Glucagon stimulates thyroid function. Endocrinology. 1970 Oct;87(4):701–709. doi: 10.1210/endo-87-4-701. [DOI] [PubMed] [Google Scholar]
  3. Chan V., Smith M., Hale P. J., Landon J. Thyroid function in the neonate. Clin Endocrinol (Oxf) 1973 Oct;2(4):333–337. doi: 10.1111/j.1365-2265.1973.tb01719.x. [DOI] [PubMed] [Google Scholar]
  4. Dussault J. H., Hobel C. J., Distefano J. J., 3rd, Erenberg A., Fisher D. A. Triiodothyronine turnover in maternal and fetal sheep. Endocrinology. 1972 May;90(5):1301–1308. doi: 10.1210/endo-90-5-1301. [DOI] [PubMed] [Google Scholar]
  5. Eddy R. L., Jones A. L., Hirsch R. M. Effect of exogenous glucagon on pituitary polypeptide hormone release. Metabolism. 1970 Oct;19(10):904–912. doi: 10.1016/0026-0495(70)90088-0. [DOI] [PubMed] [Google Scholar]
  6. Erenberg A., Phelps D. L., Lam R., Fisher D. A. Total and free thyroid hormone concentrations in the neonatal period. Pediatrics. 1974 Feb;53(2):211–216. [PubMed] [Google Scholar]
  7. Fisher D. A., Odell W. D. Acute release of thyrotropin in the newborn. J Clin Invest. 1969 Sep;48(9):1670–1677. doi: 10.1172/JCI106132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Langer P., Ponec J., Cvecková L., Gschwendtová K., Lichardus B. Studies of the effect of adrenals on thyroid hormone release following its acute depletion by isovolemic exchange transfusion. Endokrinologie. 1972 Oct;60(2):238–246. [PubMed] [Google Scholar]
  9. Larsen P. R. Triiodothyronine: review of recent studies of its physiology and pathophysiology in man. Metabolism. 1972 Nov;21(11):1073–1092. doi: 10.1016/0026-0495(72)90038-8. [DOI] [PubMed] [Google Scholar]
  10. Lemarchand-Béraud T., Genazzani A. R., Bagnoli F., Casoli M. Thyroid function in the premature and the full term newborn. Acta Endocrinol (Copenh) 1972 Jul;70(3):445–453. doi: 10.1530/acta.0.0700445. [DOI] [PubMed] [Google Scholar]
  11. Milner R. D., Chouksey S. K., Assan R. Metabolic and hormonal effects of glucagon infusion in erythroblastotic infants. Arch Dis Child. 1973 Nov;48(11):885–891. doi: 10.1136/adc.48.11.885. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Milner R. D., Fekete M., Assan R., Hodge J. S. Effect of glucose on plasma glucagon, growth hormone, and insulin in exchange transfusion. Arch Dis Child. 1972 Apr;47(252):179–185. doi: 10.1136/adc.47.252.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Milner R. D., Wright A. D. Plasma glucose, non-esterified fatty acid, insulin and growth hormone response to glucagon in the newborn. Clin Sci. 1967 Apr;32(2):249–255. [PubMed] [Google Scholar]
  14. Ratcliffe W. A., Ratcliffe J. G., McBride A. D., Harland W. A., Randall T. W. The radioimmunoassay of thyroxine in unextracted human serum. Clin Endocrinol (Oxf) 1974 Oct;3(4):481–488. [PubMed] [Google Scholar]
  15. Suematsu H., Matsuda K., Shizume K., Nakao K. Effect of plasmapheresis on thyroid hormone section. Endocrinology. 1970 Jun;86(6):1281–1286. doi: 10.1210/endo-86-6-1281. [DOI] [PubMed] [Google Scholar]

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