| Autoimmune thyroiditis with severe hypothyroidism resistant to the treatment with high peroral doses of thyroxine: case report. | |
| | |
MedLine Citation:
|
PMID: 11137979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Female patient (42 yr) suffered from autoimmune thyroiditis resulting in severe hypothyroidism. She was treated for several years by district physician with the dose of 150 microg L-thyroxine daily. Since the level of TSH was repeatedly very high and no improvement of clinical signs has been observed, she was referred to the Medical Faculty Hospital. Thyroid ultrasound showed remarkable diffuse hypoechogenicity, thyroid scintigraphy showed enlarged thyroid with low 99mTc uptake, TRH test was normal, thin needle biopsy supported autoimmune thyroiditis. X-ray examination showed normal sella turcica and no changes in the pituitary were observed with computer tomography. In spite of increasing the dose of peroral L-thyroxine to 300 microg/d and later to 500 microg/d the clinical status and TSH level did not improve. The patient was originally suspected from malabsorption of thyroxine. However, the test with a large single peroral dose (1000 microg) of L-thyroxine showed a rapid decrease of TSH level (from 126 to 75 mU/l) and increase of total T4 level (from 18 to 64 nmol/l) within 4 hr. Later the patient has been treated with intravenous L-thyroxine (500 microg every 3-4 days for 4 weeks) which resulted in the decrease of TSH level to 10 mU/l and increase of T4 level to 80-100 nmol/l. After that it was concluded that the problem is a poor compliance of the patient who apparently does not actually take the medication, although she always claimed that she is doing so. Referring to some similar cases described in the literature the case was classified as thyroxine pseudomalabsorption. In spite that this problem has been explained to her and her relatives, she refused to take any medication and is consistently neglecting all invitations to further examinations. |
| | |
Authors:
|
J Payer; K Sladekova; S Kinova; Z Cesnakova; Z Killinger; M Krizko; I Klimes; P Langer |
Related Documents
:
|
2139679 - Cervical orthoses: the issue of patient compliance. 9113229 - Psychosocial problem assessment and end-stage renal disease patient outcomes. 17000939 - Effect of medication nonadherence on hospitalization and mortality among patients with ... 16585809 - Development of the purposeful action medication-taking questionnaire. 18297259 - Brisk walking compared with an individualised medical fitness programme for patients wi... 19568229 - The extent and determinants of prescribing and adherence with acid-reducing medications... 16450649 - Lessons from the unsuccessful 2005 nuclear non-proliferation treaty review conference. 15729659 - Explosive radiation of malpighiales supports a mid-cretaceous origin of modern tropical... 23232129 - An evaluation of the impact of an increase in community-based medical undergraduate edu... |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Endocrine regulations Volume: 34 ISSN: 1210-0668 ISO Abbreviation: Endocr Regul Publication Date: 2000 Dec |
Date Detail:
|
Created Date: 2001-01-26 Completed Date: 2001-05-17 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 9112018 Medline TA: Endocr Regul Country: Slovakia |
Other Details:
|
Languages: eng Pagination: 189-93 Citation Subset: IM |
Affiliation:
|
First Clinic of Internal Medicine, Faculty of Medicine, Comenius University, 813 69 Bratislava, Slovakia. zdenko.killinger@nextra.sk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Administration, Oral Adult Biopsy, Needle Drug Resistance Female Humans Hypothyroidism / diagnosis, drug therapy*, etiology Injections, Intravenous Patient Compliance Thyroiditis, Autoimmune / complications*, diagnosis, drug therapy Thyrotropin / blood* Thyroxine / administration & dosage*, blood* |
| Chemical | |
Reg. No./Substance:
|
7488-70-2/Thyroxine; 9002-71-5/Thyrotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Suppressive effect of active hexose correlated compound (AHCC) on thymic apoptosis induced by dexame...
Next Document: Haploinsufficiency of the human homeobox gene ALX4 causes skull ossification defects.