Department of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria,
Department of Internal Medicine I, Paracelsus Medical University of Salzburg, Salzburg, Austria.
Arch Endocrinol Metab. 2021 Oct 29;65(5):664-668. doi: 10.20945/2359-3997000000349. Epub 2021 Apr 12.
Treatment-refractory hypothyroidism is a common clinical finding. Substantial causes include poor compliance and intake failure as well as gastrointestinal diseases, such as inflammatory bowel disease and short bowel syndromes. Increasing oral dosage of levothyroxine (LT4) is not always effective. Therefore, alternative routes of administration are necessary. In this report, we evaluate alternative treatment modalities for refractory hypothyroidism and present a 28-year-old woman with intestinal drug malabsorption successfully treated by subcutaneous LT4 administration. In this patient, a parenteral form of LT4, 500 μg/5 ml, was administered subcutaneously in a split dosage regimen. Blood hormone levels returned to normal within a few days and remained stable over an 8-month follow-up period.
治疗抵抗性甲状腺功能减退症是一种常见的临床发现。主要原因包括依从性差和摄入失败以及胃肠道疾病，如炎症性肠病和短肠综合征。增加左甲状腺素（LT4）的口服剂量并不总是有效。因此，需要替代给药途径。在本报告中，我们评估了治疗抵抗性甲状腺功能减退症的替代治疗方法，并介绍了一例肠内药物吸收不良的 28 岁女性患者，通过皮下 LT4 给药成功治疗。在该患者中，给予 500μg/5ml 的 LT4 肠外制剂，采用分剂量方案皮下给药。数天内血液激素水平恢复正常，8 个月的随访期间保持稳定。
