Hypersensitivity to levothyroxine in a substitutional therapy of Hashimoto syndrome – case report

Abstract

A 25-year old women was admitted to Emergency Ward in according to severe allergic reaction. The clinical picture contained of: facial swelling, rash of the face and neck (fig. 1.), skin itching and rumor, dyspnoea with the difficulties in swallowing. The detailed interview was collected, with particular emphasis on plausible allergens. The only substance that was new in patient’s surroundings was the intake of levothyroxine in according to Hashimoto syndrome, which was diagnosed a few days before. In view of the suspicion of hypersensitivity to levothyroxine, the patient was admitted to the Clinic of Endocrinology. At first, the substitution of L-thyroxine was interrupted. Then, the preparation of L-thyroxine was changed to the liquid form and the patient started to take this under the observation of the ward’s medical personnel. After 5 days of novel preparate intake, no hypersensitivity reaction was observed – therefore the patient was discharged home with additional advice to attend the Allergology Ambulatory.