Anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia and suspected impairment of T4 to T3 conversion: a case report.
10.4097/kjae.2014.67.2.144
- Author:
Sang Hyun LEE
1
;
Jin Gu KANG
;
Moon Chol HAHM
;
Jeong Heon PARK
;
Kyung Mi KIM
;
Tae Wan LIM
;
Young Ri KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwasung, Korea. christopher@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Anesthesia;
Euthyroid;
Hyperthyroxinemia;
Hyperthyroxinemia due to decreased peripheral conversion of T4
- MeSH:
Anesthesia;
Conversion Disorder;
Hemodynamics;
Humans;
Hyperthyroxinemia*;
Hypothyroidism;
Sodium;
Thyroxine;
Triiodothyronine
- From:Korean Journal of Anesthesiology
2014;67(2):144-147
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report an anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia (elevated free thyroxine, fT4 and normal 3, 5, 3'-L-triiodothyronine, T3) and suspected impairment of conversion from T4 to T3. Despite marked hyperthyroxinemia, this patient's perioperative hemodynamic profile was suspected to be the result of hypothyroidism, in reference to the presence of T4 to T3 conversion disorder. We suspected that pretreatment with antithyroid medication before surgery, surgical stress and anesthesia may have contributed to the decreased T3 level after surgery. She was treated with liothyronine sodium (T3) after surgery which restored her hemodynamic profile to normal. Anesthesiologists may be aware of potential risk and caveats of inducing hypothyroidism in patients with euthyroid hyperthyroxinemia and T4 to T3 conversion impairment.
