Anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia and suspected impairment of T4 to T3 conversion: a case report
Korean Journal of Anesthesiology 2014³â 67±Ç 2È£ p.144 ~ p.147
ÀÌ»óÇö(Lee Sang-Hyun) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
°Áø±¸(Kang Jin-Gu) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
ÇÔ¹®Ã¶(Hahm Moon-Chol) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
¹ÚÁ¤Çå(Park Jeong-Heon) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
±è°æ¹Ì(Kim Kyung-Mi) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
ÀÓÅ¿Ï(Lim Tae-Wan) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
±è¿µ¸®(Kim Young-Ri) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
Abstract
We report an anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia (elevated free thyroxine, fT4 and normal 3, 5, 3¡¯-L-triiodothyronine, T3) and suspected impairment of conversion from T4 to T3. Despite marked hyperthyroxinemia, this patient¡¯s perioperative hemodynamic profile was suspected to be the result of hypothyroidism, in reference to the presence of T4 to T3 conversion disorder. We suspected that pretreatment with antithyroid medication before surgery, surgical stress and anesthesia may have contributed to the decreased T3 level after surgery. She was treated with liothyronine sodium (T3) after surgery which restored her hemodynamic profile to normal. Anesthesiologists may be aware of potential risk and caveats of inducing hypothyroidism in patients with euthyroid hyperthyroxinemia and T4 to T3 conversion impairment.
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Anesthesia, Euthyroid, Hyperthyroxinemia, Hyperthyroxinemia due to decreased peripheral conversion of T4
KMID :
0356920140670020144
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