Mandel S H, Magnusson A R, Burton B T, Swanson J R, LaFranchi S H
Doernbecher Memorial Hospital for Children, Oregon Health Sciences University, Portland.
Clin Pediatr (Phila). 1989 Aug;28(8):374-6. doi: 10.1177/000992288902800808.
The clinical course of a 29-month-old girl who was referred for evaluation after ingesting ninety 0.2-mg tablets of levothyroxine is reported. Despite an initial thyroxine (T4) level of 282 micrograms/dl and a triiodothyronine (T3) level of 1,837 ng/dl at 48 hours postingestion, her symptoms were mild and included irritability, vomiting, tremor, and tachycardia. Treatment was limited to activated charcoal and propranolol. Thyroid hormone levels fell to normal by 13 days postingestion. The child's clinical course was benign. Even after massive acute ingestions of levothyroxine, children's symptoms are usually mild and may be controlled with propranolol. This conservative approach should be considered before expensive and potentially dangerous therapies are undertaken.
报告了一名29个月大女童的临床病程，该女童在摄入90片0.2毫克的左甲状腺素片后被转诊进行评估。尽管摄入药物48小时后初始甲状腺素（T4）水平为282微克/分升，三碘甲状腺原氨酸（T3）水平为1837纳克/分升，但她的症状较轻，包括易怒、呕吐、震颤和心动过速。治疗仅限于活性炭和普萘洛尔。摄入药物13天后甲状腺激素水平降至正常。患儿的临床病程呈良性。即使大量急性摄入左甲状腺素，儿童的症状通常也较轻，可用普萘洛尔控制。在采取昂贵且可能危险的治疗方法之前，应考虑这种保守方法。
