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ARTICLE |

Levothyroxine Overdose Associated With Seizures in a Young Child FREE

Kenneth Kulig, MD; Larry K. Golightly, PharmD; Barry H. Rumack, MD
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JAMA. 1985;254(15):2109-2110. doi:10.1001/jama.1985.03360150085029
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IT IS estimated that approximately 18 million prescriptions for thyroid preparations are filled annually in the United States. Based on recent data from the American Association of Poison Control Centers, it has also been estimated that some 5,600 cases of thyroid overdose occur annually in this country.1 Despite these figures, the reported cases of symptomatic patients after thyroid overdose have been few, presumably because of the generally benign nature of the subsequent clinical course. We recently were consulted on an unusual case of levothyroxine sodium poisoning in which clinical hyperthyroidism and convulsions occurred seven days after ingestion of the drug.

Report of a Case  A 30-month-old, previously healthy boy was thought to have ingested up to one hundred eighty 0.1-mg tablets of levothyroxine sodium (Synthroid) sometime between 9 and 11 AM, when his mother discovered that her pill bottle was open and that 180 tablets were missing. At 12:30

REFERENCES

White JD, Litovitz TL:  Levothyroxine poisoning . Pediatrics 1985;;75:129.
Funderburk SJ, Spaulding JS:  Sodium levothyroxine (Synthroid) intoxication in a child . Pediatrics 1970;;45:298-301.
Tenenbein M, Dean H:  Benign course after massive ingestion of levothyroxine , abstracted. Vet Hum Toxicol 1981;;23( (suppl 1) ):37.
Lehrner LM, Weir MR:  Acute ingestions of thyroid hormones . Pediatrics 1984;;73:313-317.
Nystrom E, Lindstedt G, Lundberg P-A:  Minor signs and symptoms of toxicity in a young woman in spite of massive thyroxine ingestion . Acta Med Scand 1980;;207:135-136.
May ME, Mintz PD, Lowry P, et al:  Plasmapheresis in thyroxine overdose: A case report . J Toxicol Clin Toxicol 1983;;20:517-520.
Von Hofe SE, Young RL:  Thyrotoxicosis after a single ingestion of levothyroxine . JAMA 1977;;237:1361.
Bhasin S, Wallace W, Lawrence JB, et al:  Sudden death associated with thyroid hormone abuse . Am J Med 1981;;71:887-890.
Van Huekelom SLH, Kinderen PJ, Vingerholds ACM:  Plasmapheresis in L-thyroxine intoxication . Vet Hum Toxicol 1979;;21( (suppl) ):7.
LeBoff MS, Kaplan MM, Silva JE, et al:  Bioavailability of thyroid hormones from oral replacement preparations . Metabolism 1982;; 31:900-905.

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White JD, Litovitz TL:  Levothyroxine poisoning . Pediatrics 1985;;75:129.
Funderburk SJ, Spaulding JS:  Sodium levothyroxine (Synthroid) intoxication in a child . Pediatrics 1970;;45:298-301.
Tenenbein M, Dean H:  Benign course after massive ingestion of levothyroxine , abstracted. Vet Hum Toxicol 1981;;23( (suppl 1) ):37.
Lehrner LM, Weir MR:  Acute ingestions of thyroid hormones . Pediatrics 1984;;73:313-317.
Nystrom E, Lindstedt G, Lundberg P-A:  Minor signs and symptoms of toxicity in a young woman in spite of massive thyroxine ingestion . Acta Med Scand 1980;;207:135-136.
May ME, Mintz PD, Lowry P, et al:  Plasmapheresis in thyroxine overdose: A case report . J Toxicol Clin Toxicol 1983;;20:517-520.
Von Hofe SE, Young RL:  Thyrotoxicosis after a single ingestion of levothyroxine . JAMA 1977;;237:1361.
Bhasin S, Wallace W, Lawrence JB, et al:  Sudden death associated with thyroid hormone abuse . Am J Med 1981;;71:887-890.
Van Huekelom SLH, Kinderen PJ, Vingerholds ACM:  Plasmapheresis in L-thyroxine intoxication . Vet Hum Toxicol 1979;;21( (suppl) ):7.
LeBoff MS, Kaplan MM, Silva JE, et al:  Bioavailability of thyroid hormones from oral replacement preparations . Metabolism 1982;; 31:900-905.
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