Hipotiroidismo autoimune refratário a altas doses de levotiroxina e hipocalcemia grave
Open accessAbstract
Os fatores que dificultam a normalização do TSH no hipotiroidismo merecem atenção especial já que muitos pacientes em reposição de levotiroxina (LT4) encontram-se com TSH fora da faixa normal. Apresentamos uma paciente de 50 anos com quadro de hipotireoidismo autoimune de difícil compensação, associado à anemia, hipocalcemia severa, hipomagnesemia, alterações psíquicas e perda ponderal importante. Após a compensação do hipotiroidismo somente após 325µg/dia de levotiroxina, levantou-se a hipótese de alguma síndrome disabsortiva. Confirmado diagnóstico de doença celíaca através de dosagem de anticorpo anti-gliadina. Com instituição de dieta sem glúten houve melhora dos sintomas relacionados à disabsorção, assim como diminuição da necessidade de levotiroxina para 125µg/dia. Baseando-se em estudos que comprovam a maior prevalência de doença celíaca entre pacientes com desordens autoimunes da tiróide, tem sido proposto por vários autores a realização rotineira de screening para doença celíaca nesse grupo de pacientes.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
There are case reports of increased LT4 requirements in individuals with celiac disease, lactose intolerance, and intestinal giardiasis, with reduction in LT4 requirement after institution of gluten-free or lactose-restricted diet and treatment of infection.
“There are also case reports of increased LT4 requirements in individuals with celiac disease (158,159), lactose intolerance (160), and intestinal giardiasis (161) with reduction in the LT4 requirement occurring after institution of a gluten-free or lactose-restricted diet and treatment of the infection, respectively.”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [159]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Holmes, G. K. T., & Cooke, W. T. (1984) · Cited by 2,638 · see citing works
Measurements of Serum Free Cortisol in Critically Ill Patients
Hamrahian, A. H., Oseni, T. S., & Arafah, B. M. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa020266 · Cited by 726 · cited 9× · see citing works
“O hipotireoidismo descompensado poderia ser outro fator responsável pela não resposta ao teste com ACTH.”
InfluentialFarrell, R. J., & Kelly, C. P. (2002) · New England Journal of Medicine · doi:10.1056/nejmra010852 · Cited by 688 · see citing works
Endocrinological Disorders and Celiac Disease
Collin, P., Kaukinen, K., Välimäki, M. J., & Salmi, J. (2002) · Endocrine Reviews · doi:10.1210/er.2001-0035 · Cited by 315 · see citing works
Coeliac disease and autoimmune thyroid disease.
Counsell, C. E., Taha, A. S., & Ruddell, W. S. (1994) · Gut · doi:10.1136/gut.35.6.844 · Cited by 202 · see citing works
Autoimmune thyroid diseases and coeliac disease
Sategna-Guidetti, C., Bruno, M., Mazza, E., et al. (1998) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-199811000-00005 · Cited by 92 · see citing works
Celiac Disease-Associated Autoimmune Endocrinopathies
Kumar, V., Rajadhyaksha, M., & Wortsman, J. (2001) · Clinical and Diagnostic Laboratory Immunology · doi:10.1128/cdli.8.4.678-685.2001 · Cited by 89 · see citing works
DESTEVEBONETTI, L., Bennet, A., Malet, D., Hoff, M., Jp, L., & Caron, P. J. (2002) · Thyroid · doi:10.1089/105072502320288519 · Cited by 35 · see citing works
The prevalence of thyroid autoantibodies in dermatitis herpetiformis
Weetman, A. P., Burrin, J. M., MACKAY, D., et al. (1988) · British Journal of Dermatology · doi:10.1111/j.1365-2133.1988.tb02431.x · Cited by 34 · see citing works
Freeman, H. J., Lemoyne, M., & Paré, P. (2002) · Best Practice & Research Clinical Gastroenterology · doi:10.1053/bega.2002.0264 · Cited by 24 · see citing works
Interference with the absorption of levothyroxine
Singh, N. K., & Hershman, J. M. (2003) · Current Opinion in Endocrinology & Diabetes · doi:10.1097/00060793-200310000-00008 · Cited by 15 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- Kumar V, Rajadhyaksha M, Wortsman JV. Celic diseases -Associated autoimmune endocrinopathies. Clin Diag Lab Immunol 2001;8:678-85.
- Weetman AP, Burrin JM, Mackay D, Leonard JN, Griffiths CEM, et al. The prevalence of thyroids autoantibodies in dermatitis herpertiformis. Br J Dermatol 1988;118:377-83.
- Sategna-Guidetti C, Bruno M, Massa E, Carlino A, Pre- debon S, Tagliabue M, et al. Autoimmune thyroid dis- ease and celiac disease. Eur J Gastroenterol 1998;10:927-31.
- Walker-Smith JA, Guandalini S, Schmitz J, Shmerling DH, Visakorpi JK. Revised criteria for diagnosis of celiac dis- ease. Arch Dis Child 1990;65:909-11.
Cited by
Sorted by citations
Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
Treatment with thyroid hormone
Biondi, B., & Wartofsky, L. (2014) · Endocrine Reviews · doi:10.1210/er.2013-1083 · Cited by 259 · see citing works
Conditions and drugs interfering with thyroxine absorption
Liwanpo, L., & Hershman, J. M. (2009) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2009.06.006 · Cited by 222 · see citing works
Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review
Skelin, M., Lucijanić, T., Amidžić Klarić, D., Rešić, A., Bakula, M., Liberati-Čizmek, A.-M., Gharib, H., & Rahelić, D. (2017) · Clinical Therapeutics · doi:10.1016/j.clinthera.2017.01.005 · Cited by 133 · see citing works
- Authors
- Silva, C. M. D. S., & Souza, M. V. L. D.
- Affiliations
- Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (BR)
- Instituto Estadual de Diabetes e Endocrinologia Luis Capriglione
- Venue
- Arquivos Brasileiros de Endocrinologia & Metabologia
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2005-08
- Volume
- 49
- Issue
- 4
- Pages
- 599-603
- ISSN
- 0004-2730 (ISSN-L)
- OpenAlex
- W2075432095
- Cited by
- 16
- References
- 11
- Citations by year
- 2019: 1 · 2017: 1 · 2014: 5 · 2013: 2 · 2012: 2
- FWCI
- 0.25
- Type
- journal article
- Language
- pt
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Arquivos Brasileiros de Endocrinologia & Metabologia (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- autoimmune hypothyroidism, refractory hypothyroidism, hypocalcemia, tetany, hypomagnesemia, celiac disease, malabsorption, gluten-free diet, TSH normalization, anemia
- MeSH terms
- Celiac Disease, Drug Resistance, Female, Humans, Hypocalcemia, Middle Aged, Severity of Illness Index, Thyrotropin, Thyroxine, Hashimoto Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
