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Thyrotoxicosis after a massive levothyroxine ingestion: A case report
Authors:Fang Du  Shi-Wei Liu  Hua Yang  Rui-Xue Duan  Wen-Xia Ren
Affiliation:Fang Du, Department of Endocrinology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan 030009, Shanxi Province, ChinaFang Du, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, ChinaShi-Wei Liu, Hua Yang, Rui-Xue Duan, Wen-Xia Ren, Department of Endocrinology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
Abstract:BACKGROUNDThe literature on thyrotoxicosis caused by excessive ingestion of exogenous thyroid hormone is limited, and most cases reported have involved pediatric clinical studies.CASE SUMMARYA 21-year-old woman initially presented with palpitation and chest tightness after an overdose of levothyroxine (10 mg). The patient transiently lost consciousness and developed atrial fibrillation during hospitalization. We used propylthiouracil to decrease the peripheral conversion of T4 to T3 and inhibit the synthesis of endogenous thyroxine, propranolol to control heart rate, hydrocortisone to correct severe thyrotoxicosis, and hemoperfusion to increase levothyroxine clearance. The patient recovered and was discharged.CONCLUSIONFor patients with thyrotoxicosis after taking excess levothyroxine, it is critical to monitor vital signs and initiate effective treatment.
Keywords:Levothyroxine   Overdose   Thyrotoxicosis   Thyroid crisis   Treatment   Case report
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