Charcoal hemoperfusion in the treatment of levothyroxine intoxication


Thyroid: Official Journal of the American Thyroid Association, v. 20, n. 2, p. 209-212, 2010.

Motivo: Produção Corpo Clínico

Setor HMV: Centro de Dialise

Área da saúde: Oncologia

Resumo: Background: Levothyroxine (l-thyroxine) intoxication may arise from intentional or accidental ingestion of excessive doses of the hormone and may cause symptoms equivalent to thyroid storm. We report a case of massive accidental l-thyroxine intoxication resulting from an error in the preparation of capsules to treat goiter. Summary: A 61-year-old woman was admitted showing high levels of thyroid hormones, with serum-free l-thyroxine level of 955.90 nmol=L (74.1 ng=mL) (normal values: 11.61–27.09 nmol=L or 0.9–2.1 ng=mL). It was discovered that she had ingested 50mg instead of 50 mg=day of l-thyroxine during 9 days. Following charcoal hemoperfusion, the levels of total thyroxine, serum-free l-thyroxine, and triiodothyronine declined dramatically, with a reproducible pattern of reduction in hormone levels observed after each of the three sessions. The patient recovered from her stuporous mental state, atrial fibrillation, and acute respiratory failure. Conclusion: The use of hemoperfusion with a charcoal filter appears to be a very important therapeutic tool for the treatment of acute and severe forms of thyrotoxicosis due to l-thyroxine intoxication.

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