Severe hypothyroidism due to the loss of therapeutic efficacy of L-thyroxine in a patient with esophageal complication associated with systemic sclerosis
Open accessAbstract
BACKGROUND: Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as systemic sclerosis (SSc). Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score. Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to l-thyroxine (l-T4) malabsorption in patients with Hashimoto's thyroiditis (HT) and SSc. CASE REPORT: Here, we report a case of a 56-year-old female affected by both SSc and HT who developed severe hypothyroidism due to the loss of therapeutic efficacy of l-T4. Therapeutic failure resulted from the altered l-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid l-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure. CONCLUSION: A recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.
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?
Systemic sclerosis and esophageal achalasia were found to cause severe hypothyroidism.
“Recently, systemic sclerosis and esophageal achalasia were found to cause severe hypothyroidism (50, 51).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [50]
A switch from LT4 tablets to liquid preparations can restore thyroid function in patients with gastrointestinal dysfunction.
“In addition, a switch from LT4 tablets to liquid preparations can restore thyroid function in patients with gastrointestinal dysfunction (Fig. 3) (32, 49, 50, 60, 65, 66).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [50]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 20 · Cited by 14
- Authors
- Lobasso, A., Nappi, L., Barbieri, L., Peirce, C., Ippolito, S., Arpaia, D., Rossi, F. W., de Paulis, A., & Biondi, B.
- Affiliations
- University of Naples Federico II (IT)
- Federico II University Hospital (IT)
- Corresponding author
- Biondi, Bernadette
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2017-09-20
- Volume
- 8
- Pages
- 241-241
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC5611405
- OpenAlex
- W2754008814
- Cited by
- 14
- References
- 20
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 5 · 2020: 1 · 2019: 2 · 2018: 2
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- severe hypothyroidism, systemic sclerosis, Hashimoto's thyroiditis, esophageal complications, thyroid autoantibodies, pericardial effusion, pulmonary hypertension, thyroid function monitoring
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
