Ramírez Stieben Luis A
Unidad de Tiroides y Paratiroides, Grupo Gamma, Rosario, Santa Fe, Argentina. E-mail:
Medicina (B Aires). 2023;83(4):622-625.
Hypothyroidism can usually be treated effectively with oral levothyroxine (LT-4) supplementation. However, hypothyroidism refractory to treatment with LT-4 is a common clinical condition. Causes include poor compliance, interactions with food or other medications, and gastrointestinal diseases, such as inflammatory bowel disease and short bowel syndromes. Increasing the oral dose of LT-4 is not always effective in these scenarios. Therefore, other routes of administration may be necessary. In this report, we evaluate alternative treatment modalities for refractory hypothyroidism and present two patients with intestinal malabsorption successfully treated by subcutaneous administration of LT-4.
甲状腺功能减退通常可以通过口服左甲状腺素（LT-4）补充剂得到有效治疗。然而，对LT-4治疗难治的甲状腺功能减退是一种常见的临床情况。原因包括依从性差、与食物或其他药物的相互作用以及胃肠道疾病，如炎症性肠病和短肠综合征。在这些情况下增加LT-4的口服剂量并不总是有效。因此，可能需要其他给药途径。在本报告中，我们评估了难治性甲状腺功能减退的替代治疗方式，并介绍了两名通过皮下注射LT-4成功治疗的肠道吸收不良患者。
