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Author: Admin | 2025-04-28
Propylthiouracil, steroids, iopanoic acid, cholestyramine, sodium idopate, and hemoperfusion lack evidence.[23456] For the management of children at risk, monitoring of vital signs and laboratory data are most important. Reviewing the scarce literature and national and international databases (http://www.toxbase.org and Poisindex [Micromedex]), Patients should be closely monitored for the clinical course during 48–72 h postingestion in those children who have ingested >0.1 mg levothyroxine/kg, children with a short interval since ingestion, symptomatic presentation. Monitoring of vital signs until 14 d postingestion is recommended based on the elimination half-life of levothyroxine and the fact that 2 weeks are needed in this case to normalize levels of TSH, fT3, and fT4. We believe that children who do not fulfill these criteria can be discharged after informing the parents/caregivers about possible (delayed onset of) symptoms and complications. As such, we think both high- and low-risk children with levothyroxine intoxication should watch for any adverse events. Follow-up All patients were followed up on the OPD basis for the next month. DISCUSSION Ingestion of large doses of levothyroxine in children generally follows a benign course. Patients may be asymptomatic or have thyrotoxic symptoms, including mild fever, tachycardia, hypertension, loose stools, and irritability.[2] Seizures may be one of the manifestations in some cases.[3] The severity of symptoms does not correlate with plasma levels of T4, and the onset of symptoms may be delayed for up to 6–11 days.[4] Asymptomatic children can be monitored at home following gastrointestinal decontamination. In cases with severe symptoms, children should be observed in the hospital for cardiac or neurological instability. Treatment for acute levothyroxine ingestion-include gastrointestinal decontamination, and administration of activated charcoal, that can decrease systemic absorption if instituted within 1-h postingestion.[7] The same protocol was followed in our cases. Our case series also followed a benign course with doses of levothyroxine
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