Intensive Care Medicine

, Volume 13, Issue 1, pp 33–38 | Cite as

Massive thyroxine intoxication: evaluation of plasma extraction

  • J. Binimelis
  • L. Bassas
  • L. Marruecos
  • J. Rodriguez
  • M. L. P. Domingo
  • P. Madoz
  • S. Armengol
  • M. A. Mangues
  • A. de Leiva
Original Articles
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Abstract

Six patients were admitted after erroneous massive intake of levothyroxine (70–1200mg over an interval of 2–12 days). All patients developed classical symptoms of thyrotoxicosis within 3 days of the first dose; five patients presented grade II–III coma and one became stuporous (days 7–10). Two patients developed left ventricular failure and three had arrhythmias (days 8–11). Total thyroid hormone levels in serum on admission ranged 935–7728 nmol/l for T4 (TT4) and 23–399 nmol/l for T3 (TT3). All patients received treatment with hydrocortisone and Propranolol. Propylthiouracil was also given in 3 cases. Extractive techniques (charcoal haemoperfusion and/or plasmapheresis) were initiated 8–14 days after the first dose of L-T4. The plasma disappearance rate (K) of TT4 with plasmapheresis was 30 times higher, on average, than under standard medical treatment (M). Also, K of TT4 under haemoperfusion was about five times higher than K under M. K changes for TT3 were higher under haemoperfusion than under plasmapheresis. Furthermore, extractive procedures shortened the average half life of TT4, (from 106.5±44.6 to 59.7±20.2 h, p<0.05).

Key words

Haemoperfusion Intoxication Plasmapheresis Thyrotoxicosis Thyroxine 
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Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • J. Binimelis
    • 1
  • L. Bassas
    • 1
  • L. Marruecos
    • 2
  • J. Rodriguez
    • 3
  • M. L. P. Domingo
    • 1
  • P. Madoz
    • 4
  • S. Armengol
    • 2
  • M. A. Mangues
    • 5
  • A. de Leiva
    • 1
  1. 1.Service of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant PauUniversitat AutónomaBarcelonaSpain
  2. 2.Service of Intensive Care Hospital de la Santa Creu i Sant PauUniversitat AutónomaBarcelonaSpain
  3. 3.Service of Biochemistry, Hospital de la Santa Creu i Sant PauUniversitat AutónomaBarcelonaSpain
  4. 4.Service of Haemotherapy, Hospital de la Santa Creu i Sant PauUniversitat AutónomaBarcelonaSpain
  5. 5.Service of Pharmacy, Hospital de la Santa Creu i Sant PauUniversitat AutónomaBarcelonaSpain

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