Euthyrox Induced Drug Rash in an Aged Patient
To the Editor: A 65-year-old woman was admitted to Peking Union Medical College Hospital because of rash with pruritus for 1 month after taking Euthyrox.Rash attacked without other symptoms 20 days after she took Euthyrox 50 μg once a day and aggravated when Euthyrox was continued for the next 2 days.The past history included partial thyroidectomy for hyperthyroidism in 1982;tuberculosis in 1990;hypertension in 2009, and cerebral hemorrhage in 2010.It was noted that the patient occurred fever and vomiting 2-3 days after antituberculosis therapy, and the symptoms alleviated 3 days after rifampicin withdrawal.Penicillin skin test was positive.The laboratory examination showed thyroid-stimulating hormone 8.78 μU/ml (normal range: 0.38-4.34 μU/ml), T3, T4, FT3, and FT4 were normal, which suggested subclinical hypothyroidism.Patch test of Euthyrox was probable positive to 25-50 μg and positive to 100-150 μg at 48-72 h, while only probable positive to letrox 150 μg.Moreover, patch test of health control showed negative.Prick test was negative of two drugs.Hence, drug rash induced by Euthyrox was diagnosed according to the laboratory test results.The condition was stable 1 week after discontinuation of Euthyrox and rash disappeared completely after 1 month.Thyroid function returned to normal 4 months after taking Letrox and no rash reappeared.
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