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Neural Regeneration Research 2014年第8期9卷 864-871页

作者： Ailing Fu Rumei Zhou Xingran Xu School of Pharmaceutical Sciences Southwest University

The thyroid hormones, triiodothyronine and thyroxine, play important roles in cognitive func- tion during the mammalian lifespan. However, thyroid hormones have not yet been used as a therapeutic agent for normal age-related cognitive deficits. In this study, CD-1 mice （aged 24 months） were intraperitoneally injected with levothyroxine （L-T4; 1.6 gg/kg per day） for 3 consecutive months. Our findings revealed a significant improvement in hippocampal cyto- skeletal rearrangement of actin and an increase in serum hormone levels of L-T4-treated aged mice. Furthermore, the survival rate of these mice was dramatically increased from 60% to 93.3%. The Morris water maze task indicated that L-T4 restored impaired spatial memory in aged mice. Furthermore, level of choline acetyltransferase, acetylcholine, and superoxide dismutase were in- creased in these mice, thus suggesting that a possible mechanism by which L-T4 reversed cognitive impairment was caused by increased activity of these markers. Overall, supplement of low-dosage L-T4 may be a potential therapeutic strategy for normal age-related cognitive deficits.

关键词： nerve regeneration brain injury hippocampus cholinergic neurons levothyroxine aging learning and memory survival rate cognitive disorder NSFC grant neural regeneration

Thyrotoxicosis after a massive levothyroxine ingestion: A case report

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World Journal of Clinical Cases 2022年第11期10卷 3624-3629页

作者： Fang Du Shi-Wei Liu Hua Yang Rui-Xue Duan Wen-Xia Ren Department of Endocrinology Taiyuan Central Hospital of Shanxi Medical UniversityTaiyuan 030009Shanxi ProvinceChina Department of Endocrinology and Metabolism West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Endocrinology Shanxi Bethune HospitalShanxi Academy of Medical SciencesTaiyuan 030032Shanxi ProvinceChina

BACKGROUND The literature on thyrotoxicosis caused by excessive ingestion of exogenous thyroid hormone is limited,and most cases reported have involved pediatric clinical *** SUMMARY A 21-year-old woman initially presented with palpitation and chest tightness after an overdose of levothyroxine(10 mg).The patient transiently lost consciousness and developed atrial fibrillation during *** used propylthiouracil to decrease the peripheral conversion of T4 to T3 and inhibit the synthesis of endogenous thyroxine,propranolol to control heart rate,hydrocortisone to correct severe thyrotoxicosis,and hemoperfusion to increase levothyroxine *** patient recovered and was *** For patients with thyrotoxicosis after taking excess levothyroxine,it is critical to monitor vital signs and initiate effective treatment.

关键词： levothyroxine Overdose Thyrotoxicosis Thyroid crisis Treatment Case report

Liver injury induced by levothyroxine tablets in a patient with hypothyroidism

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Chinese Medical Journal 2019年第16期132卷 2015-2016页

作者： Bo Wu Cheng Xie Department of Pharmacy the Affiliated Yixing Hospital of Jiangsu UniversityWuxiJiangsu 214200China Department of Pharmacy the First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 215006China

To the Editor: On March 9, 2018, a 31-year-old woman presented with liver dysfunction after thyroid cancer surgery. She was physically healthy;had no chronic diseases, such as hypertension and diabetes;had no history of infectious diseases, such as hepatitis and tuberculosis;had no history of drugs, food allergies, smoking, and alcohol consumption;and presented no obvious complaints during the disease course. B-ultrasound in the physical examination 3 years prior showed “left thyroid-occupying position.” On February 5, 2018, she had undergone surgery at our hospital. Laboratory findings on February 6, 2018 revealed white blood cells (WBCs) 9.06 × 10^9/L (3.50–9.50 × 10^9/L);neutrophils (NEs) 5.66 × 10^9/L (1.80–6.30 × 10^9/L);triiodothyronine (T3) 0.94 (0.80–2.00) ng/mL;thyroxine (T4) 6.4 (5.1–14.1)μg/dL;free T3 (FT3) 3.95 (3.10–6.80) pmol/L;free T4 (FT4) 15.57 (12.00–22.00) pmol/L;thyroid-stimulating hormone (TSH) 2.56 (0.27–4.20) mU/L;thyroid peroxidase antibody (TPOAb) 8.2 (0–34.0) IU/mL;thyroglobulin antibody (TgAb)levothyroxine tablets A (LTA;Merck KGaA, Darmstadt, Germany) 100 μg and calcium carbonate D3 tablets (CC-D3;Pfizer, China) 600 mg once daily.

关键词： levothyroxine hypothyroidism

Administration of levothyroxine 45 - 60 Minutes before Breakfast Improves Biochemical Availability as Evidenced by Reduced Thyrotropin Levels

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Open Journal of Endocrine and Metabolic Diseases 2012年第3期2卷 36-39页

作者： Shivshankar Seechurn Sanjeev Sharma Samson Oyibo Department of Diabetes and Endocrinology Peterborough City Hospital Peterborough UK

Introduction: Serum Thyrotropin (TSH) level is used to assess adequacy of levothyroxine dosing for patients with hypothyroidism. Some patients have raised TSH levels despite being on an adequate dose of levothyroxine (100 mcg/day - 200 mcg/day). Aim: To evaluated the effect of advising patients to take their levothyroxine 45 - 60 minutes before breakfast on raised serum TSH levels. Patients and Methods: Rather than increase the dose, patients with raised TSH levels were asked to take their levothyroxine at least 45 - 60 minutes before breakfast and other oral medications. Thyroid Function Tests were assessed at base line and repeated after two months. Results: Data from ten patients who presented between 2008 and 2010 were analyzed (9 females, 1 male): With median (IQR) age: 39 (33 - 49) years and duration of hypothyroidism: 6 (3 - 7.8) years. Median (IQR) levothyroxine dose was 175 (144 - 250) mcg, serum free-Thyroxine (free-T4): 13 (10.5 - 17.1) pmol/L and serum TSH: 12.63 (6.2 - 48.3) mIU/L. After two months all patients demonstrated biochemical improvement;a decrease in serum TSH to 3.15 (0.4 - 6.1) mIU/L accompanied by an increase in serum free-T4 to 17.7 (14.8 - 21.3) pmol/L. Both changes were statistically significant (p levothyroxine administration to 45 - 60 minutes before breakfast and other oral medications reduced TSH levels by 40% - 96% in all patients. We recommend this advice for all patients with hypothyroidism on adequate doses of levothyroxine but still appear biochemically under-replaced.

关键词： levothyroxine Thyrotropin Bioavailability

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

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Journal of Acute Disease 2018年第4期7卷 175-177页

作者： Yusuf Savran Tugce Mengi Merve Keskinkilic Department of Internal Medicine Medical Intensive Care Unit Dokuz Eylul University Faculty of MedicineIzmirTurkey Department of Internal Medicine Dokuz Eylul University Faculty of MedicineIzmirTurkey

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.

关键词： levothyroxine Intoxication Critical care Suicide

Protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary bypass

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Journal of Hainan Medical University 2018年第11期24卷 22-26页

作者： Ke-Qi Xie Ping Chen Wei He Zheng Liu Departments of Anesthesiology Mianyang Central Hospital in Sichuan ProvinceMianyangSichuan Province621000 Departments of Cardiothoracic Surgery Mianyang Central Hospital in Sichuan ProvinceMianyangSichuan Province6210

Objective:To study the protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary ***: Patients who underwent valve replacement under cardiopulmonary bypass in Mianyang Central Hospital between March 2015 and December 2017 were selected and randomly divided into the Euthyrox group who received preoperative levothyroxine therapy and the control group who received routine preoperative intervention. The myocardial and cerebral injury indexes, pro-inflammatory and adhesion molecules as well as antioxidant indexes were measured before operation and 12 h after ***: Twelve hours after operation, serum cTnI, LDH, CK-MB, H-FABP, NSE, S100B, CD11b/CD18, sP-selectin, IL-1 and IL-10 contents as well as SjvO2 levels of both groups were higher than those before operation whereas Cu-Zn SOD, CAT and GSH-Px contents were lower than those before operation, and serum cTnI, LDH, CK-MB, H-FABP, NSE, S100B, CD11b/CD18, sP-selectin, IL-1 and IL-10 contents as well as SjvO2 level of Euthyrox group were lower than those of control group whereas Cu-Zn SOD, CAT and GSH-Px contents were higher than those of control ***:levothyroxine has protective effect on the myocardial and cerebral ischemia reperfusion injury induced by inflammation and oxidative stress during surgery under cardiopulmonary bypass.

关键词： Cardiopulmonary bypass levothyroxine Ischemia reperfusion Inflammation Oxidative stress

Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

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World Journal of Transplantation 2024年第2期14卷 119-125页

作者： Eden M Gallegos Tanner Reed Paige Deville Blake Platt Claudia Leonardi Lillian Bellfi Jessica Dufrene Saad Chaudhary John Hunt Lance Stuke Patrick Greiffenstein Jonathan Schoen Alan Marr Anil Paramesh Alison A Smith Department of Physiology Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70124United States Department of Medicine Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Surgery Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Trauma Surgery Tacoma General HospitalTacoma 98405United States Department of Public Health Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Donation Services Louisiana Organ Procurement AgencyCovingtonLA 70433United States Department of Surgery Tulane Transplant InstituteTulane University School of MedicineNew OrleansLA 70112United States

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per *** management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management *** studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant *** To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma *** A retrospective review of adult BPODs from a single level 1 trauma center over ten years was *** criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital *** and steroid administration,the number of organs donated,the types of organs donated,and demographic information were *** analyses were performed with Plevothyroxine and steroids(ST/LT group)vs 19(22%)receiving steroids without levothyroxine(ST group).No differences were observed between the groups for gender,race,pertinent injury factors,age,or other hormone therapies used(P>0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient *** to this study include

关键词： Organ donation Trauma Brain death levothyroxine Hormone replacement therapy Steroids Organ donor Retrospective

Evaluation and management of the child with hypothyroidism

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World Journal of Pediatrics 2019年第2期15卷 124-134页

作者： Alexander K.C.Leung Alexander A.C.Leung Department of Pediatrics The University of Calgaryand The Alberta Children's Hospital#200233-16th Avenue NWCalgaryAB T2M 0H5Canada Department of Medicine The University of CalgaryCalgaryABCanada

Background Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout *** recognition and treatment of hypothyroidism is,therefore,of utmost importance to optimize physical and neurodevelopmental *** sources A PubMed search was completed in Clinical Queries using the key terms 'hypothyroidism'.Results Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism).Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism,*** than 95% of infants with congenital hypothyroidism have few,if any,clinical manifestations of *** screening programs allow early detection of congenital *** developed countries,Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and ***,iodine deficiency associated with goiter is the most common cause of *** hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary *** of the clinical features would allow prompt diagnosis and institution of *** To optimize neurocognitive outcome in infants with congenital hypothyroidism,treatment with levothyroxine should be started as soon as possible,preferably within the first 2 weeks of *** with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive *** target is to keep serum TSH < 5 mIU/L and to maintain serum free T4 or total T4 within the upper half of the age-specific reference range,with elimination of all symptoms and signs of hypothyroidism.

关键词： Dysgenesis Dyshormonogenesis Hashimoto thyroiditis Hypothyroidism Iodine deficiency levothyroxine Mental retardation Stunted growth

Treatment and follow-up of children with transient congenital hypothyroidism

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2005年第12期6卷 1206-1209页

作者： YANG Ru-lai（杨茹莱） ZHU Zhi-wei（竺智伟） ZHOU Xue-lian（周雪莲） ZHAO Zheng-yan（赵正言） Affiliated Children＇s Hospital School of Medicine Zhejiang University Hangzhou 310003 China

Objective： To study the clinical therapy and prognosis in children with transient congenital hypothyroidism （CH）. Methods： Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage levothyroxine （L-T4）. Follow-up evaluation included the determination of TT3, TT4 and TSH serum levels and the assessment of thyroid gland morphology, bone age, growth development and development quotients （DQ）. A full check-up was performed at age 2, when the affected children first discontinued the L-T4 treatment for 1 month, and one year later. Development quotients were compared with a control group of 29 healthy peers. Results： The initial L-T4 dosage administered was 3.21-5.81μg/（kg·d） with an average of （16.25±3.87）μg/d. Mean duration of therapy was （28.09±9.56） months. No significant difference was found between study group and control group in the DQ test （average score （106.58±14.40） vs （102.4±8.6）, P〉0.05） and 96.49% of the CH children achieved a test score above 85. Bone age, 99mTc scans and ultrasonographic findings were all normal, and evaluation of physical development was normal too, as were the serum levels of TT3, TT4 and TSH after one year of follow-up. Conclusion： AL-T4 dosage of 3.21-5.81μg/（kg·d） was found sufficient for the treatment of transient CH. The treated children showed satisfactory overall mental and physical development at age 2. So it is possible for CH children to stop taking medicine if their laboratory findings and physical development are all normal after regular treatment and 2-3 years of follow-up.

关键词： Transient congenital hypothyroidism levothyroxine Development quotient Follow-up

Hypothyroidism in Childhood and Adolescence

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Open Journal of Endocrine and Metabolic Diseases 2016年第1期6卷 72-77页

作者： Deise Dutra Terra Carvalho Denise Rosso Tenório Wanderley Rocha Alberto Krayyem Arbex Division of Endocrinology IPEMED Medical School Sao Paulo Brazil Visiting Scientist Harvard T. H. Chan School of Public Health Harvard University Boston USA

Juvenile hypothyroidism is an unfrequent form of hypothyroidism that affects children. If not diagnosed and treated properly, it may cause severe neurological disorders during growth. The most frequent difficulties are found in school performance, difficulties in concentration, hyperactivity or fatigue and damage on the onset of puberty. Starting levothyroxine as a drug of choice is essential, and it should be made according to the age and weight of the child. Laboratory tests for control should be requested periodically, along with a strict control of the child’s development and growth. The family-doctor relationship, along with a clear guidance on the importance of treatment, is critical to achieve a successful treatment. This article is a review about the main clinical features of hypothyroidism in childhood, especially in developing countries, providing key aspects of adherence and characteristics of its follow-up.

关键词： Thyroid Gland Neonatal Screening Hypothyroidism Congenital Hypothyroidism Juvenile Hypothyroidism levothyroxine