Diagnosis and treatment of levothyroxine pseudomalabsorption.

Many causes of malabsorption of levothyroxine in patients with hypothyroidism have been thoroughly described in literature. Pseudomalabsorption, poor compliance of the patient with the therapy regime, is the most common cause of failure of levothyroxine therapy. Pseudomalabsorption is characterised by a deficient diagnostic process, patient denial and difficulties in treatment. The present article provides guidelines in diagnosing and treating pseudomalabsorption in hypothyroidism.

[Diagnostic image (128). A boy who refused to walk. Spondylodiscitis LIV-LV]. / Diagnose in beeld (128). Een jongetje dat niet meer lopen wil. Spondylodiscitis LIV-LV.

One week after a fall from his buggy, a 2-year-old boy was seen at the first-aid department because he refused to walk. A bone scan and MRI revealed spondylodiscitis at the left side of the discus Liv-Lv and a psoas abscess.