Tenenbein M, Dean H J
Pediatr Emerg Care. 1986 Mar;2(1):15-7. doi: 10.1097/00006565-198603000-00004.
Management of thyroid hormone ingestion is controversial. We present nine children with massive levothyroxine ingestion who experienced a benign course. Their serum thyroxine levels ranged from 19.9 to 84.7 micrograms/dl. Seven were clinically euthyroid, and the other two had mild symptoms. No specific therapy was given. We recommend gastrointestinal decontamination procedures and serum thyroxine levels for an ingestion of greater than 2.0 mg of levothyroxine (or its equivalent). If levothyroxine has been ingested, neither immediate hospitalization nor prophylactic antihyperthyroidism therapy is recommended. If the initial serum thyroxine level is significantly elevated, close outpatient follow-up, especially during days three to 10, is warranted. However, massive ingestion of thyroid extract or triiodothyronine may require immediate hospitalization for observation. Therapeutic interventions aimed at extracorporeal removal of excess thyroid hormones are not recommended. Specific antithyroid therapy should be reserved for those rare patients with significant symptoms of thyrotoxicosis.
甲状腺激素摄入的管理存在争议。我们报告了9名大量摄入左甲状腺素的儿童，他们病程良性。他们的血清甲状腺素水平在19.9至84.7微克/分升之间。7名儿童临床甲状腺功能正常，另外两名有轻微症状。未给予特殊治疗。对于摄入超过2.0毫克左甲状腺素（或其等效物）的情况，我们建议进行胃肠道去污程序并检测血清甲状腺素水平。如果摄入了左甲状腺素，不建议立即住院或进行预防性抗甲状腺功能亢进治疗。如果初始血清甲状腺素水平显著升高，则需要进行密切的门诊随访，尤其是在第3至10天。然而，大量摄入甲状腺提取物或三碘甲状腺原氨酸可能需要立即住院观察。不建议采用旨在体外清除过量甲状腺激素的治疗干预措施。特异性抗甲状腺治疗应仅用于那些有明显甲状腺毒症症状的罕见患者。
