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Weekly Intramuscular Injection of Levothyroxine following Myxoedema: A Practical Solution to an Old Crisis
Joint Authors
Taylor, Peter N.
Tabasum, Arshiya
Sanki, Gina
Burberry, David
Tennant, Brian P.
White, James
Okosieme, Onyebuchi
Aldridge, Andrew
Das, Gautam
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-11-05
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
An 82-year-old female with known hypothyroidism was admitted to hospital after being found on the floor.
On examination, she was unkempt, confused, bradycardic, hypothermic, and barely arousable.
Initial biochemistry revealed a thyroid stimulating hormone (TSH) of >100 mU/L and free thyroxine (FT4) level of 1.5 pmol/L which supported a diagnosis of myxoedema coma.
She was resuscitated and commenced on liothyronine, levothyroxine, and hydrocortisone and some improvement was made.
It became apparent that she was hiding and spitting out her oral levothyroxine including levothyroxine elixir.
Given the need for prompt alternative control, we sought advice from international experts where intramuscular levothyroxine was recommended.
She was managed from day 50 onwards with intramuscular levothyroxine 200 mcg once a week, which was subsequently increased to 500 mcg.
Thyroid function normalized and she made continual cognitive and physical progress and was discharged to a rehabilitation hospital.
Her intramuscular levothyroxine was stopped and she was subsequently restarted on oral levothyroxine, with a plan for on-going close monitoring of her thyroid function.
This report highlights the potential to use intramuscular levothyroxine in individuals with severe hypothyroidism arising from poor compliance with levothyroxine treatment or other potential causes such as impaired absorption.
American Psychological Association (APA)
Taylor, Peter N.& Tabasum, Arshiya& Sanki, Gina& Burberry, David& Tennant, Brian P.& White, James…[et al.]. 2015. Weekly Intramuscular Injection of Levothyroxine following Myxoedema: A Practical Solution to an Old Crisis. Case Reports in Endocrinology،Vol. 2015, no. 2015, pp.1-3.
https://search.emarefa.net/detail/BIM-1058390
Modern Language Association (MLA)
Taylor, Peter N.…[et al.]. Weekly Intramuscular Injection of Levothyroxine following Myxoedema: A Practical Solution to an Old Crisis. Case Reports in Endocrinology No. 2015 (2015), pp.1-3.
https://search.emarefa.net/detail/BIM-1058390
American Medical Association (AMA)
Taylor, Peter N.& Tabasum, Arshiya& Sanki, Gina& Burberry, David& Tennant, Brian P.& White, James…[et al.]. Weekly Intramuscular Injection of Levothyroxine following Myxoedema: A Practical Solution to an Old Crisis. Case Reports in Endocrinology. 2015. Vol. 2015, no. 2015, pp.1-3.
https://search.emarefa.net/detail/BIM-1058390
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1058390