2.A Case of Seizure Induced by Levothyroxine Intoxication in Euthyroidism.
Jin Woo YANG ; Jin Goo LEE ; Seung Hun OH ; Hyun Jung LEE ; Won Joo KIM
Journal of the Korean Neurological Association 2001;19(5):550-552
No abstract available.
Hyperthyroidism
;
Seizures*
;
Thyroxine*
3.Evaluation of activated charcoal on the adsorption of thyroxine in experimantal rabbits
Journal of Medical and Pharmaceutical Information 2003;0(11):37-39
A research was carried out on 75 rabbits weighted from 2-2.5 kg. The two general types of charcaol used in the experiment were powdered and suspension activated charcoal. Both of powdered and suspension activated charcoal had been sufficient adsorption of thyroxine ingested. Activated charcoal administered 1g/kg body weight 5 minutes after dosing with thyroxine 10mcg/kg had possibily of adsorption of thyroxine ingested better than that administered 0.6g/kg. There was no significant difference in possibility of adsorption of thyroxine ingested between powdered and suspension actived charcoal
Thyroxine
;
Charcoal
;
Rabbits
;
animals
4.Congenital Hypothyroidism in children – A cross-sectional study in a tertiary centre in Malaysia
Azriyanti Anuar Zaini ; Yu Feng Tung ; Nor Faizal Ahmad Bahuri ; Muhammad Yazid Jalaludin
Journal of the ASEAN Federation of Endocrine Societies 2020;35(1):62-67
Introduction:
The causes of congenital hypothyroidism (CHT) are thyroid dysgenesis (TD), dyshormonogenesis (TDH) or transient hypothyroidism (TH).
Methodology:
This is a cross-sectional study looking at data over a period of 16 years (2000-2016). Confirmed cases had thyroid scan at the age of 3-years-old and repeated TFT (after 6 weeks off medications). Relevant data was collected retrospectively.
Results:
Forty (60% female) children with CHT were included in the study. Thirty (75%) children presented with high cord TSH. Nine (23%) presented after 2 weeks of life. Majority were diagnosed with TDH (42.5%) with TD and TH of 40% and 17.5% respectively. Median cord TSH of children with TD was significantly higher compared to TDH and TH (p=0.028 and p=0.001 respectively). L-thyroxine doses were not significantly different between TD, TDH and TH at diagnosis or at 3 years.
Conclusions
TDH is highly prevalent in our population. TD may present after 2 weeks of life. One in five children treated for CHT had TH. Differentiating TD, TDH and TH before initiating treatment remains a challenge in Malaysia. This study provides clinicians practical information needed to understand the possible aetiologies from a patient’s clinical presentation, biochemical markers and treatment regime. Reassessing TH cases may be warranted to prevent unnecessary treatment.
Thyroid Dysgenesis
;
Thyroxine
5.Weekly versus daily Levothyroxine Tablet Replacement in Adults with Hypothyroidism: A meta-analysis
Harold Henrison Chiu ; Ramon Larrazabal Jr. ; Angelique Bea Uy ; Cecilia Jimeno
Journal of the ASEAN Federation of Endocrine Societies 2021;36(2):156-160
Objectives:
Daily levothyroxine is the treatment of choice and standard of care in hypothyroidism, sufficient to restore thyroid stimulating hormone (TSH) to normal range. For many patients, daily lifelong therapy is required, making adherence a major issue. In such cases, weekly replacement may be a suitable alternative to improve adherence. In this study, we aimed to determine the efficacy and safety of weekly levothyroxine replacement among adults with hypothyroidism.
Methodology:
Electronic databases were searched. Two reviewers (HCC and RBL) independently screened the abstracts, reviewed full-text papers, critically appraised the quality of included studies using PRISMA guidelines. Meta-analysis was performed using the random-effects model. The primary outcome is the difference in serum TSH levels between weekly and daily administration, while secondary outcomes included adverse events and symptoms of hypothyroidism.
Results:
The primary outcome is the difference in serum TSH levels between weekly and daily administration. Secondary outcomes included adverse events and clinical symptoms. The study included two randomized trials (n=109) in the primary analysis. The difference in TSH levels was 1.78 mIU/mL higher [(95% confidence interval (CI): 1.28 to 2.28, p<0.00001] at 6 weeks and 1.22 mIU/mL higher (95% CI: 0.76 to 1.67, p<0.00001) at 12 weeks for the weekly regimen. There was no significant heterogeneity between the two groups. There was no significant difference in hypothyroid symptoms and adverse events before and after levothyroxine treatment within each group.
Conclusions
Weekly levothyroxine resulted in less suppression and higher mean serum TSH levels, while still remaining within the normal reference range. It may be a suitable alternative for non-adherent patients. However, larger randomized trials with longer duration of follow-up are needed to firmly establish its role.
Hypothyroidism
;
Thyroxine
;
Thyroid Hormones
6.Successful Oral Levothyroxine Desensitization in a patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A case report
Chua Yi Jiang ; Bay Shing Shen ; Taye Zhi Yun ; Carolina Singarayar ; Foo Siew Hui
Journal of the ASEAN Federation of Endocrine Societies 2021;36(2):213-215
Levothyroxine remains the standard therapy for patients with hypothyroidism worldwide. Levothyroxine allergy is rarely seen and alternative therapies are less efficacious and scarcely available. The use of liothyronine (LT3) monotherapy is less favoured due to its short half-life and unpredictable pharmacological profile. We report a 59-year-old male with a hypersensitivity reaction to levothyroxine who was successfully desensitized with oral levothyroxine within a day using a 14-step protocol.
Thyroxine
;
Hypersensitivity
;
Hypothyroidism
7.Use of combination of Oral Levothyroxine and Liothyronine in severe Hypothyroidism with Massive Pericardial Effusion
Poh Shean Wong ; Sue Wen Lim ; Chin Voon Tong ; Masni Mohamad ; Zanariah Hussein
Journal of the ASEAN Federation of Endocrine Societies 2022;37(2):106-112
Thyroid hormone plays an important role in cardiovascular function. Pericardial effusions are commonly seen in cases of severe hypothyroidism. However, large to massive pericardial effusions with cardiac tamponade are exceptionally rare. Herein, we present two cases of severe hypothyroidism with massive pericardial effusion. Our first case demonstrates that a patient with large pericardial effusion can be managed conservatively with aggressive thyroid hormone replacement therapy. In our second case, pericardiocentesis was performed in addition to thyroid hormone replacement therapy as the underlying aetiology of effusion could not be reasonably limited to hypothyroidism. These two cases served to highlight and demonstrate rapid normalisation of thyroid function test by using aggressive oral thyroid hormone replacement therapy using liothyronine, in combination with levothyroxine, which led to resolution of pericardial effusion and prevent its re-accumulation.
Pericardial Effusion
;
Thyroxine
;
Triiodothyronine
8.A case report on severe hypothyroidism associated with complete bilateral ptosis: A rare presentation
Deepak Jain ; H. K. Aggarwal ; Shaveta Dahiya
Journal of the ASEAN Federation of Endocrine Societies 2016;31(1):65-67
Thyroid hormones exert a major control over many vital functions of the human body and thus have an important role in maintaining homeostasis. Therefore, the hypothyroid state is associated with a wide spectrum of symptoms affecting almost all bodily functions. Among the major organs affected, nervous system and body metabolism are severely affected. Facial appearance, including ocular changes, is a characteristic of the hypothyroid state. The most prominent ocular features of hypothyroidism include loss of eyelashes and eyebrows, especially on the temporal side, puffiness of the eyelids, ocular irritation and ocular protrusion. Mild drooping of the eyelids is also seen in some patients due to loss of sympathetic tone; however the occurrence of complete bilateral ptosis is rare in the setting of hypothyroidism. Our patient, who presented with sudden onset bilateral ptosis, had no manifestations of diseases involving the ocular structure, cranial nerves or central nervous system primarily; the cause may be attributed to severe hypothyroidism considering the dramatic response to thyroxine replacement therapy.
Hypothyroidism
;
Thyroxine
;
Myokymia
10.Double ectopic thyroid gland in a 10-year-old Filipino boy
Tomas Joaquin C. Mendez ; Cecilia Gretchen Navarro Locsin
Philippine Journal of Otolaryngology Head and Neck Surgery 2018;33(1):47-50
Objective:
To present a case of a double ectopic thyroid gland in a 10-year old boy and discuss the pros and cons of the different management options that were available.
Methods:
Design: Case Report.
Setting: Tertiary Hospital in Metro Manila.
Subject: One (1).
Results:
A 10-year-old boy presented with hoarseness and easy fatigability for 6 years. Rigid endoscopy and CT scan showed an infraglottic mass originating from the anterior tracheal wall causing obstruction. Biopsy revealed thyroid tissue with atypia. Thyroid scintigraphy showed uptake in the submental and midline anterior neck. Thyroid hormone levels were consistent with hypothyroidism. Levothyroxine returned hormone levels to normal and resulted in complete regression of the mass with no symptoms of dyspnea, stridor or bleeding.
Conclusion
The management of ectopic thyroid presents a challenge as there are no guidelines for optimal treatment. Thyroid hormone insufficiency is a frequent occurrence, and emphasis must be given to its monitoring. Surgery in a critical airway lesion such as this may be reserved for cases where the patient experiences dyspnea and stridor or lack of response to thyroid hormone treatment.
Thyroid Dysgenesis
;
Thyroid Hormones
;
Thyroxine