We report a 39-year-old female who underwent a total thyroidectomy as treatment for a thyroid papillary cancer. She suffered several episodes of mild angioedema in lips and tongue, after using different commercial Levothyroxine formulations, with and without excipients. Given the need to use this drug, the patient was admitted in our hospital and we proceeded to desensitize her with oral Levothyroxine. The patient fasted throughout the whole procedure, was properly monitored and had an adequate peripheral venous access. On the first day of the procedure, a 15-step protocol was performed, first administering placebo and then, compounded formulations of Levothyroxine starting from 0.01 ug, followed by doubling doses every 15 minutes until the cumulative dose of 111.95 ug was completed, corresponding to the daily dose of Levothyroxine her endocrinologist prescribed (112 ug). The patient was monitored at baseline, between each dose and up to 3 hours after the procedure was completed. There were no incidents such as urticaria, angioedema, or others. On the second day, the patient received a single-full dose of 112 ug on an empty stomach. The medication was successfully tolerated and she was discharged. Thereafter, she tolerates daily Levothyroxine.
Pruebas diagnósticas no validadas para alergia alimentaria Non validated diagnostic tests for food allergySeñor Editor, El diagnóstico de alergia alimentaria se basa fundamentalmente en una historia clínica detallada y examen físico minucioso. De acuerdo al tipo de cuadro clínico del paciente, algunas pruebas clínicas y exámenes de laboratorio son utilizados como herramientas de apoyo diagnóstico. El tratamiento depende de las características clínicas y otras variables que deben ser consideradas cuidadosamente por el médico tratante.En base a la evidencia disponible a la fecha, las pruebas validadas para el estudio de alergias alimentarias son: prick test, IgE específicas, test de parches sólo en algunos cuadros específicos, y el test de provocación oral 1 .Múltiples pruebas no convencionales (como por ejemplo NAET, ALCAT y biorresonancia, entre otras) han sido planteadas como nuevos métodos diagnósticos, sin embargo, carecen de plausibilidad biológica, no están estandarizadas, y su utilidad no ha sido demostrada en estudios clínicos adecuados para este fin 2 . Es importante informar a los pacientes los potenciales riesgos derivados del uso de estas técnicas no validadas por la literatura, con especial énfasis en las extensas restricciones alimentarias que se suelen indicar en base a sus resultados. Los consensos internacionales en alergia alimentaria no recomiendan estas pruebas como herramientas complementarias ni alternativas, e incluso desaconsejan su uso 1 .Tomando en consideración estos precedentes, la Sociedad Chilena de Alergia e Inmunología no valida el uso de pruebas diagnósticas no convencionales en el diagnóstico de alergia alimentaria.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.