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Polish Society of
Endocrinology
Liquid levothyroxine in the treatment of myxoedema coma
21.05.2023
Grzegorz Sokołowski, Marcin Motyka, Aleksandra Gillis-Januszewska, Agnieszka Stefańska, Alicja Hubalewska-Dydejczyk
Myxoedema coma, also known as myxoedema crisis, is the most serious complication of untreated or highly inadequately treated hypothyroidism. Its most common symptoms include decreased mental status, hypothermia, and multiple organ disorders, mostly involving the cardiovascular and nervous system. Myxoedema coma is a life-threatening condition; therefore, early treatment initiation is extremely important. The recommended treatment involves intravenous administration of thyroid hormones, but due to infrequent occurrence of myxoedema coma, intravenous levothyroxine (LT4) is not always immediately available in Polish conditions (direct import, short expiration date of the drug). Thus, liquid levothyroxine administered through a gastric tube seems to be a good alternative. This article presents 3 cases of patients with myxoedema coma and severe hypothyroidism who received liquid LT4 (Tirosint-SOL) and achieved an increase in serum free thyroxine and resolution of the life-threatening condition associated with thyroid hormone deficiency.