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Appropriate intravenous doses of L-thyroxine and magnesium in a thyroidectomized patient with thyroid and parathyroid carcinomas receiving total parenteral nutrition during acute necrotizing pancreatitis.
- Source :
-
Internal medicine (Tokyo, Japan) [Intern Med] 1995 Mar; Vol. 34 (3), pp. 176-82. - Publication Year :
- 1995
-
Abstract
- A totally thyroidectomized patient with thyroid and parathyroid carcinomas, which had developed after neck irradiation in childhood, became hypercalcemic due to pulmonary metastases. The hypercalcemia was ameliorated by intermittent iv administration of bisphosphonate for 3.5 years, but this gradually became refractory to the bisphosphonate treatment. After right thoracotomy for resection of pulmonary metastases, acute necrotizing pancreatitis developed. The patient was therefore placed on total parenteral nutrition supplemented with T4 and a restricted dose of magnesium. Thyroxine(T4) (30 micrograms/day, iv) was not sufficient to maintain euthyroidism, but a higher dose (60 micrograms/day) elicited mild hyperthyroidism to the same extent as that elicited by an oral dose of 100 micrograms/day. The present case showed that the appropriate iv dose of T4 in this thyroidectomized patient with acute pancreatitis was about 60% of the oral dose. Furthermore, bisphosphonates (pamidronate and alendronate) and magnesium depletion were very effective in controlling the hypercalcemia.
- Subjects :
- Acute Disease
Carcinoma, Papillary secondary
Female
Humans
Injections, Intravenous
Lung Neoplasms secondary
Lung Neoplasms therapy
Middle Aged
Necrosis
Pancreatitis etiology
Pancreatitis pathology
Parathyroid Neoplasms etiology
Parenteral Nutrition, Total
Thyroid Neoplasms etiology
Thyroid Neoplasms pathology
Thyroidectomy
Carcinoma, Papillary therapy
Magnesium administration & dosage
Pancreatitis therapy
Parathyroid Neoplasms therapy
Thyroid Neoplasms therapy
Thyroxine administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0918-2918
- Volume :
- 34
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Internal medicine (Tokyo, Japan)
- Publication Type :
- Academic Journal
- Accession number :
- 7787323
- Full Text :
- https://doi.org/10.2169/internalmedicine.34.176