title: Choreathetosis due to abuse of levothyroxine.
abstract: Choreathetosis due to thyrotoxicosis is a rare movement disorder of acute onset. Here we present the first report of choreathetosis secondary to abuse of levothyroxine. A 35-year-old woman with autoimmune thyroiditis tripled her daily levothyroxine intake and lost 20 kg of weight during the following 6 months. She soon developed incapacitating choreathetosis. When levothyroxine was reduced to her usual dosage, all symptoms vanished in 7 days. The prompt effect of dose correction points towards a direct influence of levothyroxine on the basal ganglia; alternatively, the effects of levothyroxine might have been indirect and, possibly, autoimmune-mediated. Abuse of levothyroxine and related thyroid-tropic substances should be included into the differential diagnosis of acute choreathetosis.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kondziella
authors.forename: Anke
authors.initials: A
authors.lastname: Brederlau
authors.forename: Fredrik
authors.initials: F
authors.lastname: Asztely
mesh_terms: D000328:Adult; D001264:Athetosis / Q000139:chemically induced* / Q000175:diagnosis; D002819:Chorea / Q000139:chemically induced* / Q000175:diagnosis; D004409:Dyskinesia, Drug-Induced / Q000209:etiology*; D005260:Female; D006801:Humans; D013971:Thyrotoxicosis / Q000139:chemically induced* / Q000150:complications*; D013974:Thyroxine / Q000506:poisoning*
chemical_list: D013974:Thyroxine