Thyroid Hormone Toxicity Differential Diagnoses

1. Yamada M, Mori M. Mechanisms related to the pathophysiology and management of central hypothyroidism. Nat Clin Pract Endocrinol Metab. 2008 Dec. 4(12):683-94. [QxMD MEDLINE Link]. [Full Text].

2. Kang GY, Parks JR, Fileta B, Chang A, Abdel-Rahim MM, Burch HB, et al. Thyroxine and triiodothyronine content in commercially available thyroid health supplements. Thyroid. 2013 October. 23(10):1233-7. [QxMD MEDLINE Link].

3. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, et al. 2020 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th Annual Report. Clin Toxicol (Phila). 2021 Dec. 59 (12):1282-1501. [QxMD MEDLINE Link].

4. Ergul AB, Altuner Torun Y, Serbetci MC, Ozcan A, Bas VN. Clinical toxicity of acute overdoses with L-thyroxin in children. Pediatr Emerg Care. 2019 Nov. 35 (11):787-90. [QxMD MEDLINE Link].

5. Litovitz TL, White JD. Levothyroxine ingestions in children: an analysis of 78 cases. Am J Emerg Med. 1985 Jul. 3(4):297-300. [QxMD MEDLINE Link].

6. Golightly LK, Smolinske SC, Kulig KW, Wruk KM, Gelman CJ, Rumack BH. Clinical effects of accidental levothyroxine ingestion in children. Am J Dis Child. 1987 Sep. 141(9):1025-7. [QxMD MEDLINE Link].

7. FDA MedWatch Safety Alerts for Human Medical Products. Propylthiouracil (PTU). US Food and Drug Administration. Accessed: 2016-02-12.

8. Bauer LA. Simulations of Levothyroxine Bioavailability Using a Single-Dose Study Protocol. Am J Ther. 1995 Jun. 2(6):414-416. [QxMD MEDLINE Link].

9. Berkner PD, Starkman H, Person N. Acute L-thyroxine overdose; therapy with sodium ipodate: evaluation of clinical and physiologic parameters. J Emerg Med. 1991 May-Jun. 9(3):129-31. [QxMD MEDLINE Link].

10. Bosse GM, Matyunas NJ. Delayed toxidromes. J Emerg Med. 1999 Jul-Aug. 17(4):679-90. [QxMD MEDLINE Link].

11. Lehrner LM, Weir MR. Acute ingestions of thyroid hormones. Pediatrics. 1984 Mar. 73(3):313-7. [QxMD MEDLINE Link].

12. Mariotti S, Martino E, Cupini C, Lari R, Giani C, Baschieri L, et al. Low serum thyroglobulin as a clue to the diagnosis of thyrotoxicosis factitia. N Engl J Med. 1982 Aug 12. 307(7):410-2. [QxMD MEDLINE Link].

13. Seger D. Endocrine principles. Goldfrank L, ed. Goldfrank's Toxicologic Emergencies. 5th ed. New York, NY: McGraw-Hill; 1994. 338-90.

14. Singh GK, Winterborn MH. Massive overdose with thyroxine,--toxicity and treatment. Eur J Pediatr. 1991 Jan. 150(3):217. [QxMD MEDLINE Link].

15. Tunget CL, Clark RF, Turchen SG, Manoguerra AS. Raising the decontamination level for thyroid hormone ingestions. Am J Emerg Med. 1995 Jan. 13(1):9-13. [QxMD MEDLINE Link].

16. Lexicomp. Levothyroxine: Drug information. Available at https://www.uptodate.com/contents/levothyroxine-drug-information. Accessed: 11 March 2022.

Amanda Lu, MD Resident Physician, Department of Emergency Medicine, Naval Medical Center San Diego

Amanda Lu, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

William D Goldenberg, MD Assistant Professor, Department of Emergency Medicine, Uniformed Services University of the Health Sciences; Staff Emergency Physician, Naval Medical Center San Diego

William D Goldenberg, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents' Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Fred Harchelroad, MD, FACMT, FAAEM, FACEP Attending Physician in Emergency Medicine and Medical Toxicology, Excela Health System

Fred Harchelroad, MD, FACMT, FAAEM, FACEP is a member of the following medical societies: American College of Medical Toxicology

Disclosure: Nothing to disclose.

Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Lisandro Irizarry, MD, MBA, MPH, FACEP Chair, Department of Emergency Medicine, Wyckoff Heights Medical Center

Lisandro Irizarry, MD, MBA, MPH, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Jeffrey Glenn Bowman, MD, MS Consulting Staff, Highfield MRI

Disclosure: Nothing to disclose.

Nadine A Youssef, MD Assistant Professor, Department of Emergency Medicine, Tufts University School of Medicine

Nadine A Youssef, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Anton A Wray, MD, FACEP  Assistant Professor of Clinical Emergency Medicine, New York Medical College; Program Director Department of Emergency Medicine, Wyckoff Heights Medical Center

Anton A Wray, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association

Disclosure: Nothing to disclose.

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