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Studies on the Nature of Thyroidal Suppression During Acute Falciparum Malaria: Integrity of Pituitary Response to TRH and Alterations in Serum T₃ and Reverse T₃

Department of Endocrinology and Metabolisjn, Walter Reed Army Institute of Research Washington, D.C. 20012
Department of Medicine, Columbia University College of Physicians and Surgeons and the Presbyterian Hospital New York, New York 10032

Requests for reprints to: Leonard Wartofsky, M.D., Endocrinology and Metabolism Service (Ward 30),Department of Medicine, Walter Reed Army MedicalCenter, Washington, D.C. 20012.

The nature of the suppression of the pituitary-thyroid axis during infection was studied by testing the integrity of thyrotropin (TSH) and prolactin (PRL) responses to thyrotropin-releasing hormone (TRH) during acute falciparum malaria in human volunteers. During infection, TSH responses to TRH were found to be intact while PRL secretion was slightly increased. That serum T₃ levels abruptly declined during infection while serum T₄ was stable or increasing suggested an alteration in peripheral degradative pathways and prompted the measurement of reverse T₃. Changes in serum T₃ concentration were found to be accompanied by reciprocal changes in reverse T₃. These observations allow some clarification of previously unknown aspects of thyroidal economy during infection.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.

Received March 22, 1976.