A severe case of levothyroxine intoxication successfully treated in intensive care unit

作     者：Yusuf Savran Tugce Mengi Merve Keskinkilic 

作者机构：Department of Internal Medicine Medical Intensive Care UnitDokuz Eylul University Faculty of MedicineIzmirTurkey Department of Internal MedicineDokuz Eylul University Faculty of MedicineIzmirTurkey 

出 版 物：《Journal of Acute Disease》 (急性病杂志（英文版）)

年 卷 期：2018年第7卷第4期

页      面：175-177页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Levothyroxine Intoxication Critical care Suicide 

摘      要：Levothyroxine intoxication is a rare clinical entity which is usually asymptomatic. However, severe symptoms such as respiratory failure, malignant hyperthermia, seizures, arrhythmia, and coma have been reported. In this case report, a patient who ingested high dose (15 mg) levothyroxine for suicide and admitted to intensive care unit was presented. There was a decrease in Glasgow coma score in the follow-up. The patient was intubated due to acute respiratory failure. Gastric lavage, activated charcoal, methylprednisolone, cholestyramine and therapeuthic plasma exchange were administered. Despite ingestion of high dose of levothyroxine, thyrotoxicosis symptoms resolved with appropriate treatment and the patient was discharged from the intensive care unit.