Rens Jr Gadaen1, Roderick F Tummers-de Lind van Wijngaarden1.
Abstract
BACKGROUND: Hypothyroid crisis, or myxoedema coma, is a rare condition with high mortality and must be treated promptly. Even though it may be unfavourable, most guidelines only focus on intravenous drug administration due to lack of data on oral treatment. METHODS/
RESULTS: The course of oral treatment in two patients admitted in our hospital is described. Patients were treated with levothyroxine 1.3 μg/kg and liothyronine 25 μg twice daily, followed after 1 week with only levothyroxine 1.3 μg/kg daily. Oral treatment was successful in both patients without complications or side-effects.
CONCLUSIONS: Oral substitution is an appropriate alternative to intravenous substitution, which has potential disadvantages and is associated with higher mortality. LEARNING POINTS: Hypothyroid crisis or myxoedema coma is a rare condition with a high mortality rate, so early diagnosis and prompt treatment are necessary.High-dose intravenous treatment is associated with higher mortality, so oral substitution may be an acceptable approach, especially as intravenous medicines are not widely available. © EFIM 2021.
BACKGROUND: Hypothyroid crisis, or myxoedema coma, is a rare condition with high mortality and must be treated promptly. Even though it may be unfavourable, most guidelines only focus on intravenous drug administration due to lack of data on oral treatment. METHODS/
RESULTS: The course of oral treatment in two patients admitted in our hospital is described. Patients were treated with levothyroxine 1.3 μg/kg and liothyronine 25 μg twice daily, followed after 1 week with only levothyroxine 1.3 μg/kg daily. Oral treatment was successful in both patients without complications or side-effects.
CONCLUSIONS: Oral substitution is an appropriate alternative to intravenous substitution, which has potential disadvantages and is associated with higher mortality. LEARNING POINTS: Hypothyroid crisis or myxoedema coma is a rare condition with a high mortality rate, so early diagnosis and prompt treatment are necessary.High-dose intravenous treatment is associated with higher mortality, so oral substitution may be an acceptable approach, especially as intravenous medicines are not widely available. © EFIM 2021.
Entities:
Keywords:
Hypothyroid crisis; myxoedema coma; oral treatment
Year: 2021
PMID： 34671573 PMCID： PMC8523370 DOI： 10.12890/2021_002752
Source DB: PubMed Journal: Eur J Case Rep Intern Med ISSN： 2284-2594