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Related Experiment Videos

Massive thyroxine intoxication: evaluation of plasma extraction.

J Binimelis, L Bassas, L Marruecos

    Intensive Care Medicine
    |January 1, 1987
    PubMed
    Summary

    Massive levothyroxine overdose caused thyrotoxicosis and coma in six patients. Extractive techniques like plasmapheresis and hemoperfusion significantly accelerated hormone removal, shortening half-life.

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    Area of Science:

    • Endocrinology
    • Clinical Toxicology

    Background:

    • Levothyroxine (L-T4) overdose can lead to severe thyrotoxicosis.
    • Massive L-T4 intake presents significant clinical challenges.

    Purpose of the Study:

    • To evaluate the efficacy of extractive techniques in managing acute levothyroxine poisoning.
    • To assess the impact of plasmapheresis and charcoal hemoperfusion on hormone clearance.

    Main Methods:

    • Case series of six patients with massive levothyroxine intake.
    • Treatment included hydrocortisone, propranolol, and in some cases, propylthiouracil.
    • Extractive techniques (plasmapheresis, charcoal hemoperfusion) were employed.

    Main Results:

    • Extractive procedures significantly increased the plasma disappearance rate (K) of total thyroxine (TT4) and total triiodothyronine (TT3).

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  • Plasmapheresis increased TT4 K 30-fold, and hemoperfusion increased it 5-fold compared to standard medical treatment.
  • Extractive methods reduced the average half-life of TT4 from 106.5 to 59.7 hours.

    • Conclusions:

    • Extractive techniques are effective in accelerating the removal of levothyroxine during overdose.
    • Plasmapheresis and hemoperfusion offer a valuable adjunct to standard medical management in severe thyrotoxicosis due to L-T4 poisoning.