Meta AnalysisID 7172
左甲状腺素过量的临床病程、管理与结局：一项系统评价
CRD42023446043
What are the characteristics, management strategies, and outcomes of overdose/toxicity of levothyroxine? All patients who took intentional or unintentional levothyroxine overdose will be added to the review. Biochemical
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Record Fields
Scalar fields from the final meta_analysis record.
- Meta Analysis Id
- 7172
- Evidence Id
- 15730
- Core Evidence Id
- 15730
- Source Meta Analysis Id
- 7159
- Herb2 Meta Analysis Id
- HBMA007159
- Crd Id
- CRD42023446043
- Title
- A systematic review of clinical course, management, and outcomes of levothyroxine overdose
- Review Question
- What are the characteristics, management strategies, and outcomes of overdose/toxicity of levothyroxine? All patients who took intentional or unintentional levothyroxine overdose will be added to the review. Biochemical evidence of induced thyrotoxicosis will be collected and wil be an inclusion criterion. Different clinical presentations will be recorded. Mean levels of the Levothyroxine dose ingested will be collected. Different management strategies will be collected. The outcomes of the various treatments will be summarised in a systematic review with summary and descriptive statistics.
- Study Type Included
- Inclusion criteria: Observational studies (case reports, case series, cross-sectional, case-control, and cohort studies). Exclusion criteria: Animal studies; Studies in a language other than English; Reviews. We cannot add any randomised controlled trials as none were identified as eligible in our preliminary search. However, if any is found in the final search, it will be added.
- Condition Being Studied
- We will primarily be studying patients who took thyroxine overdose or toxicity. Patients can or cannot have underlying hypothyroidism, which can be primary or central: Primary hypothyroidism is characterized by a high serum TSH concentration and a low serum free T4 concentration. Patients with a high serum TSH concentration and a normal serum free T4 concentration may have subclinical hypothyroidism. [1] Central hypothyroidism is characterized by a low serum T4 concentration and a serum TSH concentration that is not appropriately elevated. In this setting, differentiation must be made between pituitary (secondary hypothyroidism) and hypothalamic (tertiary hypothyroidism) disorders. [1] Other than those patients who were on levothyroxine replacement and overdosed intentionally or unintentionally, we will also add in our study all patients who took levothyroxine without being on replacement, which can be intentional or unintentional. 1. https://www.uptodate.com/contents/diagnosis-of-and-screening-for-hypothyroidism-in-nonpregnant-adults?search=hypothyroidism&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3
- Participant
- Inclusion criteria: Patients (pediatric i.e. <18, and adults i.e. >18) with a confirmed diagnosis of levothyroxine overdose evident by history of ingestion and thyrotoxicosis on laboratory workup. Exclusion criteria: Having underlying known hyperthyroidism of any other cause. Articles with secondary patient data Studies where laboratory workup does not confirm self induced thyrotoxicosis evident by raised T3 or T4 (in an otherwise euthyroid or hypothyroid patient)
- Animal
- Human Disease Modelled
- Intervention
- The presence of excessive levothyroxine will be considered as the exposure.
- Comparator Control
- Main Outcome
- Biochemical resolution of Thyrotoxocosis Measures of effect Means (with standard deviations) and medians (with Interquartile ranges) for the differences in the pre- and post-treatment values stated above.
- Outcome Measure
- Additional Outcome
- Clinical and sympomatic resolution of thyrotoxicosis. Measures of effect Means (with standard deviations) and medians (with Interquartile ranges) for the differences in the pre- and post-treatment values stated above.
- Study Method
- Systematic review
- Keyword
- Drug Overdose; Drug-Related Side Effects and Adverse Reactions; Humans; Records; Thyrotoxicosis; Thyroxine
- Contact
- Hafiz Waqas Younas [email protected]
- Organisational Affiliation
- NHS Lanarkshire
- Funding Source
- Not applicable
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Pakistan, Qatar, Scotland
- Review Stage
- Review Ongoing
- First Submission Date
- 2023-07-17
- Registration Date
- 2023-07-17
- Anticipated Start Date
- 2023-08-01
- Anticipated Completion Date
- 2023-12-01
- Title Cn
- 左甲状腺素过量的临床病程、管理与结局：一项系统评价
- Title En
- A systematic review of clinical course, management, and outcomes of levothyroxine overdose
- Bilingual Status
- complete