Du F, Liu SW, Yang H, Duan RX, Ren WX. Thyrotoxicosis after a massive levothyroxine ingestion: A case report. World J Clin Cases 2022; 10(11): 3624-3629 [PMID: 35611210 DOI: 10.12998/wjcc.v10.i11.3624]
Corresponding Author of This Article
Shi-Wei Liu, MD, Professor, Chief, Department of Endocrinology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, No. 99 Longcheng Street, Xiaodian District, Taiyuan 030032, Shanxi Province, China. lswspring6@aliyun.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2022; 10(11): 3624-3629 Published online Apr 16, 2022. doi: 10.12998/wjcc.v10.i11.3624
Thyrotoxicosis after a massive levothyroxine ingestion: A case report
Fang Du, Shi-Wei Liu, Hua Yang, Rui-Xue Duan, Wen-Xia Ren
Fang Du, Department of Endocrinology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan 030009, Shanxi Province, China
Fang Du, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Shi-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
Author contributions: Du F managed the patient and drafted the manuscript; Liu SW supervised the manuscript writing; Yang H and Ren WX developed the treatment strategies for the patient; Duan RX was responsible for the care of the patient; All authors read and approved the final manuscript.
Informed consent statement: The patient agreed to the related test, and simultaneously signed a written informed consent form for publication of her case details.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Wei Liu, MD, Professor, Chief, Department of Endocrinology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, No. 99 Longcheng Street, Xiaodian District, Taiyuan 030032, Shanxi Province, China. lswspring6@aliyun.com
Received: December 30, 2021 Peer-review started: December 30, 2021 First decision: January 25, 2022 Revised: February 1, 2022 Accepted: February 23, 2022 Article in press: February 23, 2022 Published online: April 16, 2022
Abstract
BACKGROUND
The literature on thyrotoxicosis caused by excessive ingestion of exogenous thyroid hormone is limited, and most cases reported have involved pediatric clinical studies.
CASE SUMMARY
A 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.
CONCLUSION
For patients with thyrotoxicosis after taking excess levothyroxine, it is critical to monitor vital signs and initiate effective treatment.
Core Tip: The literature on thyrotoxicosis caused by excessive ingestion of exogenous thyroid hormone is limited. We report a 21-year-old woman who presented with thyroid crisis after an overdose of levothyroxine. For patients with thyrotoxicosis or even thyroid storm after an overdose of levothyroxine, it is critical to monitor vital signs and symptoms and initiate effective treatment.
