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- W3002335838 abstract "Sir, Thyroid hormones along with estrogen, glucocorticoid, retinoids, prolactin, and growth hormone modulate hair growth.[1] Hyperthyroidism and hypothyroidism both are associated with hair shaft abnormalities.[2] Here, we report a case of an infant with congenital hypothyroidism who suffered diffuse hair loss due to levothyroxine overdose. A 9-month-old female infant, born of non consanguineous marriage, presented to our hospital with partial neck holding and developmental delay. The infant weighed 6900 g (3rd-15th percentile) and was 67 cm long (3rd-15th percentile). Physical examination revealed lethargy, hoarseness, dry skin, depressed nasal bridge, and macroglossia [Figure 1a and b]. The results of the laboratory tests were suggestive of congenital hypothyroidism (Total T3-25 ng/dL, total T4-0.01 μg/dL, TSH >150 μIU/dL). Ultrasonography of neck revealed agenesis of thyroid gland. Infant was started on levothyroxine 50 μg/day (7.24 μg/kg/day). Fifteen to twenty days after starting levothyroxine, infant's mother noticed diffuse loss of scalp hairs. On examination, infant had non-scarring alopecia involving around 50-60% of the scalp area [Figure 1c–e]. At this stage, serum T3 and T4 levels were quite high and TSH was suppressed (Serum free T3 = 6.13 pg/ml, free T4 = 2.74, TSH = 0.039 μIU/dL). Levothyroxine overdose was suspected as the cause of effluvium hence dose was reduced to 37.5 μg/day. Follow up after 45 days showed marked regrowth of hair [Figure 1f and g] which was normal in texture and distribution while on levothyoxine maintenance dose. To conclude, levothyroxine overdose may lead to hair loss and should be watched for.Figure 1: Clinical picture showing reversible scalp hair loss. (a and b) At the time of diagnosis, before starting thyroxine supplements. (c-e) 30 days after starting levothyroxine (50 μg/day). (f and h) 45 days after reducing levothyroxine doseFinancial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest." @default.
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- W3002335838 date "2019-01-01" @default.
- W3002335838 modified "2023-10-12" @default.
- W3002335838 title "Reversible hair loss due to levothyroxine overdose" @default.
- W3002335838 cites W2145829185 @default.
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- W3002335838 doi "https://doi.org/10.4103/ijem.ijem_550_19" @default.
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