Institute of Legal Medicine, University Hospital Düsseldorf, 40225, Düsseldorf, Germany.
Int J Legal Med. 2010 Nov;124(6):637-40. doi: 10.1007/s00414-010-0423-y. Epub 2010 Feb 10.
Thyroid hormones are sometimes used for purposes for which they are not approved. Reasons for off-label use can be overweight, prevailing depressive mood, or various somatic symptoms. Information about the intake of thyroid hormones in order to lose weight can be easily obtained from inappropriate/nonmedical websites. The objective of this case report is to describe the first case of a lethal abuse of liothyronine. The case was a 29-year-old male (BMI 32) without relevant illnesses. An autopsy was performed and followed by histological, toxicological, and clinical chemistry examinations. The autopsy revealed no relevant pathology. Histology showed multiple areas of focal cell necrosis in the myocardium and signs of acute heart failure including severe edema of the lungs; the follicles of the thyroid gland were markedly plump. Postmortem laboratory results indicated lethal liothyronine intoxication. Despite prevailing opinion, uncontrolled intake of liothyronine can cause lethal thyroid storm in a euthyroid patient without manifested cardiac illnesses.
甲状腺激素有时被用于未经批准的用途。非适应证使用的原因可能是超重、普遍存在的抑郁情绪或各种躯体症状。关于为了减肥而服用甲状腺激素的信息可以很容易从不适当的/非医疗网站上获得。本病例报告的目的是描述首例致命性滥用左甲状腺素的病例。该病例为一名 29 岁男性（BMI 为 32），无相关疾病。进行了尸检，并进行了组织学、毒理学和临床化学检查。尸检未发现相关病理学。组织学显示心肌多处局灶性细胞坏死，以及急性心力衰竭的迹象，包括肺部严重水肿；甲状腺滤泡明显肿胀。死后实验室结果表明存在致命性左甲状腺素中毒。尽管普遍认为，未经控制的左甲状腺素摄入可导致无明显心脏疾病的甲状腺功能正常患者发生致命性甲状腺危象。
