Unintentional Levothyroxine Ingestion by a Child: A Case Report

Abstract

Hypothyroidism is a common endocrine condition in the adult and pediatric population. Levothyroxine, used for the treatment of hypothyroidism, is one of the easily available drugs in any household as either parents or sometimes children are on levothyroxine treatment. Accidental levothyroxine ingestion is increasing nowadays. Unintentional thyroxine ingestion in children may follow diverse manifestations, ranging from asymptomatic presentation to thyrotoxic crisis. While asymptomatic children can be monitored at home, children with severe symptoms need intensive care support. A child can develop convulsions, temperature instability, and arrhythmias, among others. Here, we present the case of a three-year-old male child with a history of accidental ingestion of 3.2 mg levothyroxine. He was initially asymptomatic and developed symptoms such as tachycardia and high blood pressure after 24 hours of ingestion. He was treated with oral propranolol and prednisolone and discharged after five days. After one month, thyroid function was documented as normal.

Keywords: children; levothyroxine; prednisolone; propranolol; tachycardia.

Figure 1. Electrocardiogram on admission to the hospital.

Figure 2. Electrocardiogram changes after 24 hours of levothyroxine ingestion.