Levothyroxine toxicity: Difference between revisions
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*Chronic ingestions are more likely to present with clinical symptoms similar to [[thyrotoxicosis]] | *Chronic ingestions are more likely to present with clinical symptoms similar to [[thyrotoxicosis]] | ||
==Clinical Features== | ==Clinical Features== | ||
Although most thyroxine ingestions are mild, large acute or chronic ingestions can mirror moderate to severe thyrotoxicosis | |||
{{Thyrotoxicosis clinical features}} | {{Thyrotoxicosis clinical features}} | ||
Revision as of 03:00, 9 January 2022
Background
- Most acute thyroxine overdoses are mild.
- Chronic ingestions are more likely to present with clinical symptoms similar to thyrotoxicosis
Clinical Features
Although most thyroxine ingestions are mild, large acute or chronic ingestions can mirror moderate to severe thyrotoxicosis
Classic Triad
- Hyperthermia
- Often marked (40 - 41C)[1]
- Tachycardia
- Often out of proportion to fever [2]
- Altered mental status (agitation, confusion, delirium stupor, coma, seizure)
May also have:
- Goiter
- Thyrotoxic stare, lid retraction
- Hyperhidrosis
- Thermoregulatory dysfunction
- Central nervous system dysfunction
- Gastrointestinal-hepatic dysfunction
- Diarrhea, nausea and vomiting, abdominal pain
- Unexplained jaundice, hepatomegaly
- Cardiovascular dysfunction
- Tachycardia, palpitations
- Congestive heart failure, dyspnea
- Pedal edema
- A. fib
- Widened pulse pressure
Differential Diagnosis
- Sympathomimetic ingestion
- Atherosclerosis
- Aortic regurgitation
- Thyrotoxicosis
- Fever
- Anemia
- Pregnancy
- Anxiety
- Patent ductus arteriosus
- Heart block
- Aortic dissection
- Endocarditis
- Increased ICP
- Vasodilating drugs
- Beriberi
- Pheochromocytoma
Evaluation
Workup
Diagnosis
Management
- Management mirrors Thyroid storm treatment and depends on the degree of clinical symptoms
Disposition
See Also
External Links
References
- ↑ Thiessen, M. (2018). Thyroid and Adrenal Disorders in Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders.
- ↑ Thiessen, M. (2018). Thyroid and Adrenal Disorders in Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders.