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[Autoimmune hypothyroidism nonresponsive to high doses of levothyroxine and severe hypocalcemia].
- Source :
-
Arquivos brasileiros de endocrinologia e metabologia [Arq Bras Endocrinol Metabol] 2005 Aug; Vol. 49 (4), pp. 599-603. Date of Electronic Publication: 2005 Oct 19. - Publication Year :
- 2005
-
Abstract
- The factors that make difficult the normalization of TSH in hypothyroidism need special attention because some patients on thyroxine replacement do not maintain a normal TSH. We report a 50 year-old woman with autoimmune hypothyroidism of difficult compensation, associated with anemia, hypocalcemia with a previous episode of tetany, hypomagnesemia, psychologic alterations and important weight loss. After compensation of the hypothyroidism with doses of L-thyroxine as high as 325 microg/day, the hypothesis of a malabsorptive syndrome was raised. Celiac disease was confirmed by elevated serum antigliadin antibody. A gluten-free diet was instituted which improved the symptoms associated with malabsorption and reduced the L-thyroxine requirement to 125 microg/day. Because several studies have shown an association of both diseases, a routine screening for celiac disease has been widely proposed in patients with autoimmune thyroid disease.
- Subjects :
- Celiac Disease diagnosis
Celiac Disease diet therapy
Drug Resistance
Female
Hashimoto Disease complications
Humans
Middle Aged
Severity of Illness Index
Thyrotropin blood
Thyroxine pharmacokinetics
Celiac Disease complications
Hashimoto Disease drug therapy
Hypocalcemia complications
Thyroxine administration & dosage
Subjects
Details
- Language :
- Portuguese
- ISSN :
- 0004-2730
- Volume :
- 49
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Arquivos brasileiros de endocrinologia e metabologia
- Publication Type :
- Academic Journal
- Accession number :
- 16358091
- Full Text :
- https://doi.org/10.1590/s0004-27302005000400020