RESUMO
Pregnancy leads to many physiological changes, particularly in the thyroid. This implies that the reference values of the thyroid parameters may change according to the trimesters of the pregnancy and that the management of pregnant women differs. Establishing reference values is not easy and can be done in several ways. In our study, we review the reference values of TSH and FT4 of pregnant women followed up at Liege University Hospital compared to control women. This has been achieved using retrospective data from our laboratory. We show that the small decrease in the TSH reference values in pregnant women is barely visible in a small cohort. Our FT4 values confirm what the literature shows, i.e. a slight increase during the first trimester. We emphasize the difficulty and the relevance of making reference values for pregnant women.
La grossesse aboutit à de nombreux changements physiologiques, en particulier vis-à-vis de la fonction thyroïdienne. Ceci implique que les valeurs de référence du bilan thyroïdien changent en fonction des trimestres et que la prise en charge des femmes enceintes diffère. Établir des valeurs de référence n'est pas un travail aisé et peut être fait de plusieurs façons. Dans notre étude réalisée au CHU de Liège, nous revoyons les valeurs de référence de TSH et FT4 de femmes enceintes par rapport à des femmes contrôles. Ceci a été réalisé à partir de données rétrospectives de notre laboratoire. Nous montrons que la faible diminution des valeurs de référence de la TSH chez la femme enceinte est peu visible sur une petite cohorte. Nos valeurs de FT4 confirment ce que montre la littérature, à savoir une légère augmentation durant le premier trimestre. Nous soulignons la difficulté et la pertinence de définir des valeurs de référence chez la femme enceinte.
Assuntos
Gestantes , Glândula Tireoide , Feminino , Humanos , Gravidez , Valores de Referência , Estudos Retrospectivos , Testes de Função Tireóidea , Tireotropina , TiroxinaRESUMO
BACKGROUND: Coronavirus disease COVID-19 has become a public health emergency of international concern. Together with the quest for an effective treatment, the question of the post-infectious evolution of affected patients in healing process remains uncertain. Krebs von den Lungen 6 (KL-6) is a high molecular weight mucin-like glycoprotein produced by type II pneumocytes and bronchial epithelial cells. Its production is raised during epithelial lesions and cellular regeneration. In COVID-19 infection, KL-6 serum levels could therefore be of interest for diagnosis, prognosis and therapeutic response evaluation. MATERIALS AND METHODS: Our study retrospectively compared KL-6 levels between a cohort of 83 COVID-19 infected patients and two other groups: healthy subjects (n = 70) on one hand, and a heterogenous group of patients suffering from interstitial lung diseases (n = 31; composed of 16 IPF, 4 sarcoidosis, 11 others) on the other hand. Demographical, clinical and laboratory indexes were collected. Our study aims to compare KL-6 levels between a COVID-19 population and healthy subjects or patients suffering from interstitial lung diseases (ILDs). Ultimately, we ought to determine whether KL-6 could be a marker of disease severity and bad prognosis. RESULTS: Our results showed that serum KL-6 levels in COVID-19 patients were increased compared to healthy subjects, but to a lesser extent than in patients suffering from ILD. Increased levels of KL-6 in COVID-19 patients were associated with a more severe lung disease. DISCUSSION AND CONCLUSION: Our results suggest that KL-6 could be a good biomarker to assess ILD severity in COVID-19 infection. Concerning the therapeutic response prediction, more studies are necessary.