Use of Combination of Oral Levothyroxine and Liothyronine in Severe Hypothyroidism with Massive Pericardial Effusion

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Poh Shean Wong
https://orcid.org/0000-0002-4686-5515
Sue Wen Lim
https://orcid.org/0000-0002-5289-3838
Chin Voon Tong
https://orcid.org/0000-0002-2160-6154
Masni Mohamad
Zanariah Hussein

Abstract

Thyroid hormone plays an important role in cardiovascular function. Pericardial effusions are commonly seen in cases of severe hypothyroidism. However, large to massive pericardial effusions with cardiac tamponade are exceptionally rare.


Herein, we present two cases of severe hypothyroidism with massive pericardial effusion. Our first case demonstrates that a patient with large pericardial effusion can be managed conservatively with aggressive thyroid hormone replacement therapy. In our second case,  pericardiocentesis was performed in addition to thyroid hormone replacement therapy as the underlying aetiology of effusion  could not be reasonably limited to hypothyroidism.


These two cases served to highlight and demonstrate rapid normalisation of thyroid function test by using aggressive oral thyroid hormone replacement therapy using liothyronine, in combination with levothyroxine, which led to resolution of pericardial effusion and prevent its re-accumulation.

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How to Cite
Wong, P. S., Lim, S. W., Tong, C. V., Mohamad, M., & Hussein, Z. . (2022). Use of Combination of Oral Levothyroxine and Liothyronine in Severe Hypothyroidism with Massive Pericardial Effusion. Journal of the ASEAN Federation of Endocrine Societies. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/1875
Section
Case Series
Author Biographies

Poh Shean Wong, Hospital Melaka, Malaysia

Endocrinology Unit, Department of Medicine

Sue Wen Lim, Hospital Putrajaya, Malaysia

Endocrinology Unit, Department of Medicine

Chin Voon Tong, Hospital Melaka, Malaysia

Endocrinology Unit, Department of Medicine

Masni Mohamad, Hospital Putrajaya, Malaysia

Endocrinology Unit, Department of Medicine

Zanariah Hussein, Hospital Putrajaya, Malaysia

Endocrinology Unit, Department of Medicine

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