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Related Experiment Videos

Raising the decontamination level for thyroid hormone ingestions

C L Tunget1, R F Clark, S G Turchen

  • 1San Diego Regional Poison Center, University of California, San Diego Medical Center 92103-8925.

The American Journal of Emergency Medicine
|January 1, 1995
PubMed
Summary

Acute pediatric thyroid hormone ingestions of 5 mg levothyroxine (T4) equivalent or less are unlikely to cause significant toxicity. Most young children experienced mild symptoms, with no clear link between ingestion amount and observed effects.

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Area of Science:

  • Pediatric Toxicology
  • Endocrinology
  • Emergency Medicine

Background:

  • Acute thyroid hormone ingestions in children require careful evaluation for potential toxicity.
  • Levothyroxine (T4) is a common thyroid hormone replacement medication.
  • Understanding dose-response relationships is crucial for managing pediatric ingestions.

Purpose of the Study:

  • To determine if acute ingestions of ≤5 mg levothyroxine (T4) equivalent cause significant toxicity in pediatric patients.
  • To identify the highest tolerated milligram-per-kilogram dose of thyroid hormone in children.
  • To analyze factors influencing toxicity in pediatric thyroid hormone ingestions.

Main Methods:

  • Retrospective review of 92 pediatric cases (< or = 6 years) of acute thyroid hormone ingestions reported to a poison control center.

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  • Evaluation of patient weight, ingested dose, drug preparation, treatment, outcome, and management site.
  • Literature review to identify additional cases of pediatric thyroid hormone toxicity.

    • Main Results:

    • Eight patients (9%) experienced mild symptoms without specific medical intervention.
    • No correlation was found between the amount of thyroid hormone ingested and observed symptoms.
    • The maximum T4 dose ingested without gastrointestinal decontamination was 0.13 mg/kg (2 mg).
    • Literature review identified only one case of moderate toxicity with <5 mg T4 equivalent.

    Conclusions:

    • Significant toxicity is not expected in pediatric patients with acute ingestions of ≤5 mg levothyroxine (T4) equivalent.
    • Most pediatric levothyroxine ingestions result in mild or no symptoms.
    • The data suggest a wide margin of safety for low-dose levothyroxine ingestions in young children.