Levothyroxine poisoning in children – should we really be afraid?

Year 2023, , 247 - 251, 28.09.2023

Betül Öztürk , İlknur Bodur , Aysun Tekeli , Ali Güngör , Raziye Merve Yaradılmış , Muhammed Mustafa Güneylioğlu , Aytaç Göktuğ , Nilden Tuygun , Can Demir Karacan

https://doi.org/10.21673/anadoluklin.1240784

Abstract

Aim: L-thyroxine intoxication is rarely seen in children; however, it can be worrying for clinicians and parents. This study aimed to present the clinical and laboratory findings of children admitted to the pediatric emergency department with l-thyroxine intoxication.

Methods: Patients admitted to the pediatric emergency department with l-thyroxine intake between January 2015 and June 2022 were included in this retrospective study. The patient’s clinical characteristics, laboratory findings, treatment, and hospital costs were recorded and analyzed.

Results: This study included 33 pediatric patients with thyroxine intoxication. The median age was 35 months (The interquartile range (IQR) 25-47.5) and 19 of them were girls (57,5%). No patient had a clinical symptom at the admittance. One patient had massive l-thyroxine intake and two patients had tachycardia. Gastric lavage and activated charcoal were used in 18 patients. Four patients were followed in the pediatric intensive care unit and one of them was treated with propranolol. The median time of hospital stay was 24 hours (IQR 13,5-84). The median cost of the treatment was $73 (IQR56.2-116.75).

Conclusion: L-thyroxine intoxication usually occurs with low drug doses in children and has a benign prognosis. Routine hospitalization of these patients, particularly with low drug dose intake, should be questioned considering the treatment cost.

Keywords

Children, intoxication, l-thyroxin, poisoning, toxicity

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Çocukluk çağında levotiroksin zehirlenmesi – gerçekten korkmalı mıyız?

Abstract

Amaç: L-tiroksin zehirlenmesi çocukluk çağında az görülmesine rağmen, aileler ve klinisyenler açısından endişe verici bir durumdur. Bu çalışmada l-tiroksin zehirlenmesi ile acil servise başvuran çocukların klinik ve laboratuvar bulgularının sunulması amaçlanmıştır.

Yöntemler: L-tiroksin alımıyla Ocak 2015 – Haziran 2022 arası çocuk acil servisine başvuran hastalar geriye dönük olarak çalışmaya dahil edildi. Hastaların klinik özellikleri, laboratuvar bulguları, tedavi ve hastane masrafları kayıt ve analiz edildi.

Bulgular: Bu çalışmada tiroksin intoksikasyonu olan 33 hasta vardı. Hastaların medyan yaşı 35 ay (Interquartil Range (IQR): 25-47.5) ve hastaların 19’u kızdı (57,5%). Başvuru sırasında hiçbir hastada klinik semptom yoktu. Bir hastada masif l-tiroksin alımı varken iki hastada taşikardi mevcuttu. 18 hastada gastrik lavaj ve aktif kömür kullanıldı. 4 hasta çocuk yoğun bakımda takip edildi ve bir tanesi için propranolol tedavisi uygulandı. Ortanca hastanede kalış süresi 24 (IQR 13,5-84) saatti. Ortanca tedavi masrafı ise $73’dı (IQR56.2-116.75).

Sonuç: L-tiroksin zehirlenmesi çocuklarda sıklıkla düşük dozlarda olur ve iyi seyirlidir. Bu hastaların özellikle düşük doz alımı olanların rutin olarak hastaneye yatışı tedavi masrafları göz önüne alındığında yeniden sorgulanmalıdır.

Keywords

Çocukluk, intoksikasyon, l-tiroksin, toksisite, zehirlenme

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