Drug rash induced by levothyroxine and oral desensitization

Background

Synthetic Thyroxine (T4) is the treatment of choice for the correction of hypothyroidism.

Methods

We report a case of drug rash induced by levothyroxine and currently oral desensitization.

A 31 year-old woman had been diagnosed as Hashimoto´s Thyroiditis. She was having levothyroxine for 9 years when she begun to present bilateral eyelids maculopapular rash. Blood exams and physical examination were normal except for the eyelids´ rash.

As she stopped using levothyroxine, the rash has disappeared.

Her endocrinologist prescribed her other brands of levothyroxine, and the patient reported the same reaction.

Results

Therefore, we performed an oral desensitization with multiple doses of the drug preparation. The procedure was started at a dose of 1,00µg. Every 30 minutes the dose was increased until a total dose of 127,00µg.

After 2 months, she currently tolerates 100,00µg/d.

Conclusions

It is unusual that biological substances induce allergic reactions when given exogenously.

Once it happens, drug desensitization can be performed at a hospital by experienced professionals with satisfactory response.

Consent

Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.