Hypothyroidism leading to a syncopal episode: A reminder to check drug interactions/A case of iatrogenic hypothyroidism presented with cardioinhibitory syncope and resolved by thyroxine supplementation Reply

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dc.contributor.authorUçar, Birsen
dc.contributor.authorKılıç, Zübeyir
dc.contributor.authorKırel, Birgül
dc.contributor.buuauthorEvim, Melike Sezgin
dc.contributor.departmentUludağ Üniversitesi/Tıp Fakültesi/Pediatrik Hematoloji Anabilim Dalı.tr_TR
dc.contributor.researcheridAAH-1452-2021tr_TR
dc.contributor.scopusid36337796600tr_TR
dc.date.accessioned2022-04-11T07:48:20Z
dc.date.available2022-04-11T07:48:20Z
dc.date.issued2012-08
dc.description.abstractWe read with great interest the article: “A case of iatrogenic hypothyroidism presented with cardio-inhibitory syncope and resolved with levothyroxine supplementation” (1). Similarly we report a case of cardio-inhibitory syncope as a result of a drug interaction from an over the counter medication. A 65-year-old female with a past medical history significant for hypothyroidism, hypertension and obesity was brought into the emergency room after experiencing a syncopal episode. Electrocardiogram revealed sinus bradycardia with heart rate-40 beats/min and findings of a new first-degree atrioventricular block (PR interval 0.24 s). Head computed tomography (CT) did not reveal any evidence of an acute hemorrhagic stroke. Carotid Doppler examinations were negative for evidence of stenosis. A complete metabolic profile and complete blood count were unrevealing as well. Thyroid function studies revealed a thyroid stimulating hormone (TSH) level of 125 mIU/mL with free thyroxine (T4) of 0.19 ng/DL. Three months prior to this episode, the patients TSH was 2.2 mIU/mL. Patient had been taking levothyroxine 100 mcg every day for the past 5 years without any prior abnormalities in her thyroid function tests. Upon further questioning it was elicited that the patient had been also taking orlistat, an over the counter medication, to help lose weight under the guidance of a primary care physician. Orlistat was held immediately. Endocrinology was consulted and the patient was restarted on her home dose of levothyroxine as she had been therapeutic on prior to the initiation of levothyroxine. At a 6 month f/up, patient’s bradycardia and first degree AV block had resolved. Her repeat thyroid functions revealed TSH of 5 miu/mL and free T4 of 0.56 ng/dL. Orlistat is a gastrointestinal lipase inhibitor that reduces absorption of dietary fat by thirty percent (2). A few cases have been described in the literature to suggest that orlistat may prevent the absorption of levothyroxine. It has been proposed that orlistat may decrease the absorption of levothyroxine in the small intestine (3).en_US
dc.identifier.citationEvim, M. S. vd. (2012). "Hypothyroidism leading to a syncopal episode: A reminder to check drug interactions/A case of iatrogenic hypothyroidism presented with cardioinhibitory syncope and resolved by thyroxine supplementation Reply". Anadolu Kardiyoloji Dergisi-The Anatolian Journal of Cardiology, 12(5), 453-454.tr_TR
dc.identifier.endpage454tr_TR
dc.identifier.issn1302-8723
dc.identifier.issue5tr_TR
dc.identifier.pubmed22626661tr_TR
dc.identifier.scopus2-s2.0-84864755622tr_TR
dc.identifier.startpage453tr_TR
dc.identifier.urihttps://doi.org/10.5152/akd.2012.140
dc.identifier.urihttps://anatoljcardiol.com/en/hypothyroidism-leading-to-a-syncopal-episode-a-reminder-to-check-drug-interactions-a-case-of-iatrogenic-hypothyroidism-presented-with-cardio-inhibitory-syncope-and-resolved-by-thyroxine-supplementation-162159
dc.identifier.urihttp://hdl.handle.net/11452/25691
dc.identifier.volume12tr_TR
dc.identifier.wos000307141100030tr_TR
dc.indexed.pubmedPubMeden_US
dc.indexed.scopusScopusen_US
dc.indexed.trdizinTrDizintr_TR
dc.indexed.wosSCIEen_US
dc.language.isoenen_US
dc.publisherTürk Kardiyoloji Derneğitr_TR
dc.relation.collaborationYurt içitr_TR
dc.relation.journalAnadolu Kardiyoloji Dergisi-The Anatolian Journal of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCardiovascular system & cardiologyen_US
dc.subjectThyroid-hormone actionen_US
dc.subject.emtreeLevothyroxineen_US
dc.subject.emtreeTetrahydrolipstatinen_US
dc.subject.emtreeThyrotropinen_US
dc.subject.emtreeThyroxineen_US
dc.subject.emtreeTetrahydrolipstatinen_US
dc.subject.emtreeAgeden_US
dc.subject.emtreeCase reporten_US
dc.subject.emtreeDrug absorptionen_US
dc.subject.emtreeDrug interactionen_US
dc.subject.emtreeDrug withdrawalen_US
dc.subject.emtreeFemaleen_US
dc.subject.emtreeHumanen_US
dc.subject.emtreeHypertensionen_US
dc.subject.emtreeHypothyroidismen_US
dc.subject.emtreeIatrogenic diseaseen_US
dc.subject.emtreeLetteren_US
dc.subject.emtreeObesityen_US
dc.subject.emtreePatient monitoringen_US
dc.subject.emtreeSinus bradycardiaen_US
dc.subject.emtreeSyncopeen_US
dc.subject.emtreeThyrotropin blood levelen_US
dc.subject.emtreeThyroxine blood levelen_US
dc.subject.emtreeHypothyroidismen_US
dc.subject.emtreeSyncopeen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHypothyroidismen_US
dc.subject.meshSyncopeen_US
dc.subject.meshThyroxineen_US
dc.subject.scopusHyperthyroidism; Thyroid Hormones; Thyrotoxicosisen_US
dc.subject.wosCardiac & cardiovascular systemsen_US
dc.titleHypothyroidism leading to a syncopal episode: A reminder to check drug interactions/A case of iatrogenic hypothyroidism presented with cardioinhibitory syncope and resolved by thyroxine supplementation Replyen_US
dc.title.alternativeHipotiroidizm senkop epizoduna götürüyor: İlaç etkileşimlerini kontrol etmek için bir hatırlatma/ Tiroksin tedavisi ile düzelen kardiyo-inhibitör senkop ile gelen iyatrojenik hipotiroidili bir vakatr_TR
dc.typeLetter
dc.wos.quartileQ4en_US

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