Initial low-dose oral levothyroxine in a child with Down syndrome, myxedema, and cardiogenic shock

Annika Janson; Cathrin Hällström; Magnus Iversen; Mikael Finder; Amira Elimam; Ricard Nergårdh

doi:10.1002/ccr3.2169

Initial low-dose oral levothyroxine in a child with Down syndrome, myxedema, and cardiogenic shock

Clin Case Rep. 2019 May 20;7(7):1291-1296. doi: 10.1002/ccr3.2169. eCollection 2019 Jul.

Authors

Annika Janson^{1

2}, Cathrin Hällström³, Magnus Iversen³, Mikael Finder^{4

5}, Amira Elimam^{1

5}, Ricard Nergårdh^{1

2}

Affiliations

¹ Department of Pediatrics Karolinska University Hospital Huddinge Huddinge Sweden.
² Department of Children's and Women's Health Karolinska Institutet Solna Sweden.
³ Department of Intensive Care Medicine Karolinska University Hospital Huddinge Huddinge Sweden.
⁴ Department of Neonatology Karolinska University Hospital Huddinge Huddinge Sweden.
⁵ Department of Clinical Sciences, Intervention and Technology Karolinska Institutet Solna Sweden.

Abstract

Myxedema is extremely rare in children, and guidelines are lacking. We treated a 12-year-old girl with myxedema and cardiogenic shock with initial low dose (0.3-2.5 μg/kg body weight/day) of oral levothyroxine and intensive care. Oral administration may safely revert children's myxedema in a dosage resembling that for hypothyroidism.

Keywords: Down syndrome; cardiogenic shock; hypothyroidism; levothyroxine; myxedema; thyroxine.

Publication types

Case Reports