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Hyperthyroidism and nonischaemic cardiomyopathy: case report A 65-year-old woman developed hyperthyroidism and non-ischaemic cardiomyopathy during treatment with levothyroxine sodium for hypothyroidism. The woman, who had a history of hypothyroidism and end-stage renal disease caused by focal segmental glomerular sclerosis, presented for kidney transplant evaluation. She had been receiving levothyroxine sodium [levothyroxine] 1.28 µg/kg daily [route not stated]. She neither had a known cardiac history nor other relevant history. Less than 1 month following listing for transplant, she experienced an episode of chest pain for a day. An ECG diastolic dysfunction and an estimated LVEF of 25% to 30%. An ECG revealed left bundle branch block. Cardiac catheterization showed mild coronary artery disease. Based on these findings, she was diagnosed with non-ischemic cardiomyopathy. After these tests, she experienced anxiety, insomnia, hair loss and a 22-kg weight loss in 6 months. A thyroid panel showed TSH 0.108 µIU/mL and high free T4 levels, a change from her status 7 year prior and she was on unchanged levothyroxine sodium dose. Based on these findings, she was diagnosed with hyperthyroidism [duration of treatment to reactions onsets not stated]. The woman’s dose of levothyroxine sodium was reduced to 0.85 µg/kg daily. Her other medications included alprazolam, colchicine, lisinopril, estradiol, omeprazole, rosuvastatin and torsemide, which were not related to cardiomyopathy. Naranjo scale showed score of 8 indicated probable causal relationship between levothyroxine sodium and non-ischaemic cardiomyopathy. Following 6 weeks, TSH and free T4 levels normalised. Cardiac functions normalised after 4 months. Also, her anxiety, insomnia, and hair loss also resolved. Girone G, et al. Levothyroxine-Induced Nonischemic Cardiomyopathy in a Kidney Transplant Candidate. Annals of Pharmacotherapy 54: 1260-1262, No. 12, Dec 2020. 803500521 Available from: URL: http://doi.org/10.1177/1060028020928957

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Reactions 12 Sep 2020 No. 1821