title: More than one way to skin a thyroid. Managing pediatric hypothyroidism with weekly intramuscular levothyroxine.
abstract: BACKGROUND
  Oral levothyroxine (L-T4) supplementation is usually an effective therapy in pediatric hypothyroidism, except in patients with malabsorption or pseudomalabsorption. In these cases, parenteral L-T4 may be required, but there is a paucity of information about this delivery method in the pediatric population.
  
  
  METHODS
  We present three cases of pediatric patients with primary hypothryoidism unresponsive to oral L-T4 that were successfully treated with intramuscular (IM) L-T4.
  
  
  CONCLUSIONS
  This is the first pediatric case series of successful IM L-T4 therapy in refractory primary hypothyroidism. Our case series demonstrates that once weekly IM L-T4 dosing may be a safe and well tolerated treatment regimen for pediatric patients.
authors.forename: Patria
authors.initials: P
authors.lastname: Alba
authors.forename: Naim
authors.initials: N
authors.lastname: Mitre
authors.forename: Max
authors.identifier: http://orcid.org/0000-0002-5686-4620
authors.initials: M
authors.lastname: Feldt
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy*; D007273:Injections, Intramuscular; D013974:Thyroxine / Q000008:administration & dosage*
chemical_list: D013974:Thyroxine