Appropriate Intravenous Doses of L-Thyroxine and Magnesium in a Thyroidectomized Patient with Thyroid and Parathyroid Carcinomas Receiving Total Parenteral Nutrition During Acute Necrotizing Pancreatitis
| Autor: | K. Shiratori, Keizo Kasono, Toru Miyamoto, Yoko Kasagi, Shozo Toraya, Kanji Sato, Takao Obara, Hiroshi Demura, Izumi Fukuda, Yuko Mandai |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms medicine.medical_treatment Effective dose (radiation) Gastroenterology Necrosis Internal medicine Internal Medicine medicine Humans Magnesium Thyroid Neoplasms business.industry Thyroid Thyroidectomy General Medicine Middle Aged Bisphosphonate medicine.disease Carcinoma Papillary Surgery Thyroxine Parathyroid Neoplasms medicine.anatomical_structure Parenteral nutrition Pancreatitis Parathyroid carcinoma Acute Disease Injections Intravenous Acute pancreatitis Female Parenteral Nutrition Total business |
| Zdroj: | Internal Medicine. 34:176-182 |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.34.176 |
| Popis: | A totally thyroidectomized patient with thyroid and parathyroid carcinomas, which had developed after neck irradiation in childhood, became hypercalcemic due to pulmonary metastases. The hypercalcemia was ameliorated by intermittent iv administration of bisphosphonate for 3.5 years, but this gradually became refractory to the bisphosphonate treatment. After right thoracotomy for resection of pulmonary metastases, acute necrotizing pancreatitis developed. The patient was therefore placed on total parenteral nutrition supplemented with T4 and a restricted dose of magnesium. Thyroxine(T4) (30 micrograms/day, iv) was not sufficient to maintain euthyroidism, but a higher dose (60 micrograms/day) elicited mild hyperthyroidism to the same extent as that elicited by an oral dose of 100 micrograms/day. The present case showed that the appropriate iv dose of T4 in this thyroidectomized patient with acute pancreatitis was about 60% of the oral dose. Furthermore, bisphosphonates (pamidronate and alendronate) and magnesium depletion were very effective in controlling the hypercalcemia. |
| Databáze: | OpenAIRE |
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