title: [Levothyroxine poisoning: clinical manifestations and therapeutic management].
abstract: Intoxication with L-tyroxine has a low prevalence, high prevalence is observed in pediatric age. Toxic dose is unclear, asymptomatic patients have been observed with doses under 5 mg. Systems with high prevalence of symptoms are cardiovascular system, sympathetic nervous system and gastrointestinal tube. Symptoms could appear from hours to days after ingestion. Early hours after L-tyroxine ingestion, levels of T4 and T3 are not related with severity. However, monitoring seric levels is necessary to lead therapeutic approach and to give a prognosis. Daily determinations of T3, T4 and TSH are necessaries. Determinations of temperature, arterial pressure and blood heart rate are needed to control complications. Beta-blockers and intestinal decontamination drugs are used during therapeutic approach. Other therapeutic options are iopanoic acid and propylthiouracil. In summary, intoxication with L-tyroxine could be a severe situation. It is necessary to describe therapeutic protocols in this entity.
authors.affiliation: Intituto de Endocrinología y Nutrición, Hospital Universitario Río Hortega, Valladolid.
authors.forename: D A
authors.initials: DA
authors.lastname: de Luis
authors.forename: L
authors.initials: L
authors.lastname: Abad
authors.forename: R
authors.initials: R
authors.lastname: Aller
authors.forename: M
authors.initials: M
authors.lastname: González-Sagrado
authors.forename: A
authors.initials: A
authors.lastname: Dueñas
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D013956:Antithyroid Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000188:drug therapy; D002648:Child; D002792:Cholestyramine Resin / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D009422:Nervous System Diseases / Q000139:chemically induced; D011041:Poisoning / Q000175:diagnosis / Q000628:therapy; D011433:Propranolol / Q000627:therapeutic use; D013963:Thyroid Hormones / Q000097:blood; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000506:poisoning*
chemical_list: D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents; D013963:Thyroid Hormones; D002792:Cholestyramine Resin; D013972:Thyrotropin; D011433:Propranolol; D013974:Thyroxine