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Changes in thyroid function tests induced by 2 month carbamazepine treatment in L-thyroxine-substituted hypothyroid children.
Eur J Pediatr 1986; 145(1-2):77-9EJ

Abstract

In five L-thyroxine-substituted hypothyroid children with partial epilepsy serum total thyroxine (T4) and free T4 (FT4) significantly (P less than 0.01) decreased following 2 months of carbamazepine (CBZ) administration (20 mg/kg per BW per day) from mean (+/- SD) values of 12.7 +/- 1.1 micrograms/dl and 15.5 +/- 1.8 pg/ml to mean values of 7.5 +/- 2.3 and 10.1 +/- 1.7, respectively. In all but one patient important changes in both serum total and free triiodothyronine (T3, FT3) were not observed; consequently T3:T4 and FT3:FT4 ratios significantly (P less than 0.05) increased in the whole series. Three subjects had post-treatment serum TSH that rose to hypothyroid levels parallel to a T4 decrease. The negligible thyroid hormone secretion and the unmodified T3-uptake (T3U) or T4-binding globulin (TBG) exclude direct effects of CBZ on thyroid gland and on carrier serum proteins, respectively. The findings observed, instead, might be due to accelerated T4 metabolic clearance together with augmented T4 to T3 conversion rate, as previously demonstrated for diphenylhydantoin. The sharp reduction in T4 and FT3 concentrations is the peripheral display of this event, which is associated with a decompensation of the metabolic status, as indicated by serum TSH enhancement. In all cases a supplement of L-thyroxine by itself was able to restore euthyroid TSH serum concentrations, suggesting that hypothyroidism in patients with partial epilepsy to whom CBZ had been administered requires a higher L-T4 substitutive regimen.

Authors

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Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

3089800

Citation

De Luca, F, et al. "Changes in Thyroid Function Tests Induced By 2 Month Carbamazepine Treatment in L-thyroxine-substituted Hypothyroid Children." European Journal of Pediatrics, vol. 145, no. 1-2, 1986, pp. 77-9.
De Luca F, Arrigo T, Pandullo E, et al. Changes in thyroid function tests induced by 2 month carbamazepine treatment in L-thyroxine-substituted hypothyroid children. Eur J Pediatr. 1986;145(1-2):77-9.
De Luca, F., Arrigo, T., Pandullo, E., Siracusano, M. F., Benvenga, S., & Trimarchi, F. (1986). Changes in thyroid function tests induced by 2 month carbamazepine treatment in L-thyroxine-substituted hypothyroid children. European Journal of Pediatrics, 145(1-2), pp. 77-9.
De Luca F, et al. Changes in Thyroid Function Tests Induced By 2 Month Carbamazepine Treatment in L-thyroxine-substituted Hypothyroid Children. Eur J Pediatr. 1986;145(1-2):77-9. PubMed PMID: 3089800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in thyroid function tests induced by 2 month carbamazepine treatment in L-thyroxine-substituted hypothyroid children. AU - De Luca,F, AU - Arrigo,T, AU - Pandullo,E, AU - Siracusano,M F, AU - Benvenga,S, AU - Trimarchi,F, PY - 1986/4/1/pubmed PY - 1986/4/1/medline PY - 1986/4/1/entrez SP - 77 EP - 9 JF - European journal of pediatrics JO - Eur. J. Pediatr. VL - 145 IS - 1-2 N2 - In five L-thyroxine-substituted hypothyroid children with partial epilepsy serum total thyroxine (T4) and free T4 (FT4) significantly (P less than 0.01) decreased following 2 months of carbamazepine (CBZ) administration (20 mg/kg per BW per day) from mean (+/- SD) values of 12.7 +/- 1.1 micrograms/dl and 15.5 +/- 1.8 pg/ml to mean values of 7.5 +/- 2.3 and 10.1 +/- 1.7, respectively. In all but one patient important changes in both serum total and free triiodothyronine (T3, FT3) were not observed; consequently T3:T4 and FT3:FT4 ratios significantly (P less than 0.05) increased in the whole series. Three subjects had post-treatment serum TSH that rose to hypothyroid levels parallel to a T4 decrease. The negligible thyroid hormone secretion and the unmodified T3-uptake (T3U) or T4-binding globulin (TBG) exclude direct effects of CBZ on thyroid gland and on carrier serum proteins, respectively. The findings observed, instead, might be due to accelerated T4 metabolic clearance together with augmented T4 to T3 conversion rate, as previously demonstrated for diphenylhydantoin. The sharp reduction in T4 and FT3 concentrations is the peripheral display of this event, which is associated with a decompensation of the metabolic status, as indicated by serum TSH enhancement. In all cases a supplement of L-thyroxine by itself was able to restore euthyroid TSH serum concentrations, suggesting that hypothyroidism in patients with partial epilepsy to whom CBZ had been administered requires a higher L-T4 substitutive regimen. SN - 0340-6199 UR - https://www.unboundmedicine.com/medline/citation/3089800/Changes_in_thyroid_function_tests_induced_by_2_month_carbamazepine_treatment_in_L_thyroxine_substituted_hypothyroid_children_ DB - PRIME DP - Unbound Medicine ER -