ABSTRACT
Levothyroxine (T4) (Eltroxin) poisoning is a rare clinical entity which is usually asymptomatic. It can occur accidently, mostly in children, and can happen intentionally in adults with suicidal intention especially psychiatric patients. Thyrotoxicosis from an overdose of medicinal thyroid hormone is a condition that may be associated with a significant delay in onset of toxicity. However, severe symptoms such as respiratory failure, malignant hyperthermia, seizures, arrhythmia, and coma have been reported. In this case report, we present a patient who ingested high doses of levothyroxine i.e., 90 tab. of Eltroxin 100 mcg, for suicidal intension and admitted to intensive care unit. She is an euthyroid person but took these tablets, which her mother was taking Eltroxin tablets for hypothyroidism. Gastric lavage was done with activated charcoal, Inj. Hydrocortisone, Tab Propranolol and Tab Neomercazole administered. Despite ingestion of high dose of levothyroxine, thyrotoxicosis symptoms like palpitations resolved with appropriate treatment and the patient was discharged after complete recovery.
ABSTRACT
Objective To investigate the effects of sympathetic excitation and dendritic cell activation on myocar-dial injury in LPS-induced rats. Methods The rats were randomly divided into four groups:control group, LPS group ( intraperitoneal injection of LPS 10 mg/kg) ,intervention group ( given beta receptor blocker Ate 5 mg/kg after LPS administration) and DC inhibitor VAG539 intervention group ( VAG539 30 mg/kg gavage twice a day for 2 days after LPS administration) respectively . The powerlab system was used to record the hemodynamic and sympathetic data. The concentration of norepinephrine ( NE) in plasma was measured by high performance liquid chromatography ( HPLC) , and the expression and positive cells of TNF-α and DCs in myocardium were detected by immunohistochemistry. Results Compared with the control group, the plasma NE level significantly increased ( P＜0.05) ;The expression of TNF-α and DCs in heart tissue significantly increased ( P＜0.05) ;the renal sym-pathetic nerve activity (SNA) significantly increased in the three groups after LPS administration for 24 hours. Compared with the LPS group, the plasma NE level significantly decreased ( P＜0.05 ) ; The expression of TNF-α and DCs in heart tissue significantly decreased ( P＜0.05) ;the renal SNA significantly decreased after Ate and VAG539 administration(P＜0.05).Conclusions Excessive activation of sympathetic nervous system and activation of DC aggravate myocardial injury in LPS-induced rats.