JAMA · 1991
Pseudomalabsorption of levothyroxine.
Клинический случайСтатьяПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Ain K B, Refetoff S, Fein H G, Weintraub B D
Аннотация
OBJECTIVE: --The issue of patient compliance with pharmacological therapy vs malabsorption of medication was explored in the context of persistent hypothyroidism despite the administration of large doses of levothyroxine sodium.
DESIGN: --Retrospective case series.
SETTING: --Referred care in two large tertiary care centers.
PATIENTS: --Four patients, seen within two decades, with clinical and biochemical hypothyroidism while receiving levothyroxine, were evaluated for selective malabsorption of this hormone.
INTERVENTIONS: --Studies included serial measurements of thyroid hormone levels after a loading dose of levothyroxine or liothyronine sodium or evaluation with a double-labeled thyroxine tracer technique. Results were compared with studies of levothyroxine malabsorption in the medical literature.
RESULTS: --All patients were ultimately found to have normal (82% to 100%) absorption of oral levothyroxine. There was no evidence that malabsorption of levothyroxine can occur as an isolated abnormality.
CONCLUSIONS: --Some patients exhibit a factitious disorder suggesting malabsorption of levothyroxine. When treating hypothyroidism, psychiatric issues may result in noncompliance with levothyroxine therapy.
DESIGN: --Retrospective case series.
SETTING: --Referred care in two large tertiary care centers.
PATIENTS: --Four patients, seen within two decades, with clinical and biochemical hypothyroidism while receiving levothyroxine, were evaluated for selective malabsorption of this hormone.
INTERVENTIONS: --Studies included serial measurements of thyroid hormone levels after a loading dose of levothyroxine or liothyronine sodium or evaluation with a double-labeled thyroxine tracer technique. Results were compared with studies of levothyroxine malabsorption in the medical literature.
RESULTS: --All patients were ultimately found to have normal (82% to 100%) absorption of oral levothyroxine. There was no evidence that malabsorption of levothyroxine can occur as an isolated abnormality.
CONCLUSIONS: --Some patients exhibit a factitious disorder suggesting malabsorption of levothyroxine. When treating hypothyroidism, psychiatric issues may result in noncompliance with levothyroxine therapy.