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Author: Admin | 2025-04-28
All euthyroid. All patients T4, T3 blood levels were increased at the 2nd day. Despite a high dose of ingested levothyroxine and very high thyroid hormone levels, patients showed mild clinical symptoms, limited to a tachycardia. Children seem to be more tolerant of massive overdoses of levothyroxine when compared with adults but can develop moderate-to-severe toxicity following acute levothyroxine ingestions. It is suggested that higher production of reverse T3 (rT3) is responsible for the decreased risk of a thyroid storm after a levothyroxine overdose. rT3 is an isomere T3, which is also derived from T4 deionization. It binds to the thyroid hormone receptors and thereby blocks the action of T3.[7] The activated charcoal might have protected by binding levothyroxine to cations and thus decreasing absorption.[8] Comparison of the clinical course with previously reported cases The majority of previously reported studies have described mild symptoms in acute levothyroxine overdose, despite high amounts of levothyroxine taken (dosages up to 18 mg levothyroxine).[2345] Symptoms include tachycardia, fever, irritability, hyperactivity, diarrhea, abdominal pain, and hypertension. Tunget et al.[8] even suggested that acute ingestions of levothyroxine et al.[4] reported a case of a tonic-clonic seizure in a 3.5-year-old boy on the 3rd day after ingestion of a maximum of 3.6 mg levothyroxine (about 0.22 mg/kg). Rarely, massive thyroid hormone overdose has led to grand mal seizures,[4] thyroid storm, and even coma,[6] particularly in adults. Overall, previous reports suggest that there is no dose-response relationship between the occurrence or severity of symptoms and the amount levothyroxine ingested. Even patients with a relatively low dose of levothyroxine potentially develop seizures, and it is not possible to predict which patients will become symptomatic. CONCLUSIONS Levothyroxine tablet is colorful and palatable that can be attractive to young children. Gastric lavage and activated charcoal are the mainstays of treatment in
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