Successful oral desensitization to levothyroxine

Demirel, Fevzi; Güleç, Mustafa; Özgür, Kemal; Taş, Çetin; Baysan, Abdullah; Yeşillik, Sait; Muşabak, Uğur; Şener, Osman

doi:10.1016/j.anai.2013.06.003

Cited by 11 publications

(11 citation statements)

References 7 publications

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“…Most desensitization protocols in human medicine have been developed for nonbiological drugs . However, there are some reports of desensitization for insulin allergy and two reports of desensitization in levothyroxine‐allergic human patients . Until now, no desensitization has ever been investigated to address any type of drug allergy in veterinary medicine.…”

Section: Discussionsupporting

confidence: 72%

“…In that case the dog apparently suffered an idiosyncratic reaction to one of the inactive ingredients of the thyroid supplement rather than the hormone itself. Despite numerous discussions of such a reaction on professional medical sites, the human literature contains a limited number of published cases . Interestingly, most human cases appear to be “immediate” reactions (i.e.…”

Section: Discussionmentioning

confidence: 99%

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Potential cutaneous hypersensitivity reaction to an inactive ingredient of thyroid hormone supplements in a dog

Lavergne

Fosset

Kennedy³

et al. 2015

Veterinary Dermatology

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These elements strongly suggest that this dog had an idiosyncratic reaction (likely immune-mediated) against one or both inactive ingredients in the first two formulations of levothyroxine. We are not aware of any previous confirmed delayed hypersensitivity to a thyroid supplement in a dog with the likely chemical trigger being an inactive ingredient rather than the therapeutic agent itself. We hope that this case will raise awareness about allergic reactions to thyroid supplements and allergic reactions to inactive formulation components.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Potential cutaneous hypersensitivity reaction to an inactive ingredient of thyroid hormone supplements in a dog

Lavergne

Fosset

Kennedy³

et al. 2015

Veterinary Dermatology

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“…En la literatura, existen escasos reportes de alergia a la levotiroxina 7,12,13,14,15 y ninguno, hasta nuestro conocimiento, para liotironina.…”

Section: Discussionunclassified

“…El tratamiento de reemplazo hormonal con levotiroxina es ampliamente utilizado y las reacciones de hipersensibilidad son infrecuentes. Se manifiestan principalmente como urticaria, angioedema, exantema eccematoso, fiebre y disfunción hepática 7 .…”

Section: Servicio Alergología Hospitalunclassified

“…Se revisó la literatura, donde existen escasos casos descritos de alergia y desensibilización a levotiroxina y optamos por seguir la pauta del grupo de Fevzi et al de Ankara, modificada 7 , partiendo con dosis de 0,01 ug, las que se doblaron cada 15 min, hasta llegar a la dosis acumulada de 111,95 ug a las 3 h y media de haberse iniciado el procedimiento, sin incidentes alérgicos, el primer día de nuestra intervención. En agosto de 2016, se efectuó el procedimiento en ayunas, con vía venosa permeable y paciente monitorizada, con control de signos vitales y flujometría basalmente, entre cada dosis y 15, 45 y 120 min después de finalizar el procedimiento (Tabla 2).…”

Section: Caso Clínicounclassified

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Desensibilización a levotiroxina. Caso clínico

et al. 2018

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We report a 39-year-old female who underwent a total thyroidectomy as treatment for a thyroid papillary cancer. She suffered several episodes of mild angioedema in lips and tongue, after using different commercial Levothyroxine formulations, with and without excipients. Given the need to use this drug, the patient was admitted in our hospital and we proceeded to desensitize her with oral Levothyroxine. The patient fasted throughout the whole procedure, was properly monitored and had an adequate peripheral venous access. On the first day of the procedure, a 15-step protocol was performed, first administering placebo and then, compounded formulations of Levothyroxine starting from 0.01 ug, followed by doubling doses every 15 minutes until the cumulative dose of 111.95 ug was completed, corresponding to the daily dose of Levothyroxine her endocrinologist prescribed (112 ug). The patient was monitored at baseline, between each dose and up to 3 hours after the procedure was completed. There were no incidents such as urticaria, angioedema, or others. On the second day, the patient received a single-full dose of 112 ug on an empty stomach. The medication was successfully tolerated and she was discharged. Thereafter, she tolerates daily Levothyroxine.

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Practical Application of Levothyroxine-Based Therapy

Akamizu

2021

70 Years of Levothyroxine

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Successful oral desensitization to levothyroxine

Cited by 11 publications

References 7 publications

Potential cutaneous hypersensitivity reaction to an inactive ingredient of thyroid hormone supplements in a dog

Potential cutaneous hypersensitivity reaction to an inactive ingredient of thyroid hormone supplements in a dog

Desensibilización a levotiroxina. Caso clínico

Practical Application of Levothyroxine-Based Therapy

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