Case Report ： Anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia and suspected impairment of T4 to T3 conversion -a case report

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 profi...

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Bibliographic Details
Published in:Korean journal of anesthesiology 2014-08, Vol.67 (2), p.144
Main Authors: Sang Hyun Lee, Jin Gu Kang, Moon Chol Hahm, Jeong Heon Park, Kyung Mi Kim, Tae Wan Lim, Young Ri Kim
Format: Article
Language:Korean
Subjects:
Anesthesia
Euthyroid
Hyperthyroxinemia
Hyperthyroxinemia due to decreased peripheral conversion of T4
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Summary: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 T 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. (Korean J Anesthesiol 2014; 67: 144-147)
ISSN:2005-6419