Treatment-resistant hypothyroidism due to storage of levothyroxine at cold temperature
R. Moncorvo Filho, 90 - Centro, Rio de Janeiro - RJ, 20211-340, Brazil.
Case Study
GSC Advanced Research and Reviews, 2022, 12(01), 084–090.
Article DOI: 10.30574/gscarr.2022.12.1.0186
Publication history:
Received on 09 June 2022; revised on 13 July 2022; accepted on 15 July 2022
Abstract:
We present a case of a 37-year-old woman who was referred to the Endocrinology Department of the State Institute for Diabetes and Endocrinology Luiz Capriglione, Rio de Janeiro, Brazil, with persistent hypothyroidism following a total thyroidectomy for multinodular goiter 6 months before the appointment. After the surgery, the patient was prescribed levothyroxine 100μg/day. Initial blood tests showed increased thyroid stimulating hormone and normal free thyroxine levels. Over the next 2 years, in spite of the patient’s adherence to the treatment and progressive increments in levothyroxine doses, thyroid stimulating hormone levels remained elevated and she developed clinical hypothyroidism. She was then admitted to the hospital for clinical and hormonal stabilization. Upon further investigation, the patient informed that at the beginning of her levothyroxine treatment, she was instructed to store the drug in the refrigerator, at 4°C. Seven days after impatient treatment, thyroid stimulating hormone levels returned to normal and the subject was asymptomatic. After discharge, she was instructed to store the medication properly, at room temperature, and away from heat and light. Two years after discharge, she was still euthyroid and asymptomatic.
Keywords:
Hypothyroidism; Levothyroxine; Cold temperature; Malabsorption; Drug resistance
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Copyright © 2022 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0
