I have not come across this but the BNF does sugge
Dear Caroline
I have not come across this but the BNF does suggest there is an
interaction between chloral and I/V frusemide which may displace thyroid
hormone from binding sites so perhaps higher doses have this effect.
Graham Ball
Chelsea and Westminster
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Jagger Caroline
Sent: 07 October 2005 13:41
To: [log in to unmask]
Subject: Chloral and Thyroid function tests
Dear All
Does anyone have any experience of transient increases in fT4 and fT3
post administration of chloral for sedation? We have at least 3 children
(ages 5 to 17) whose results have had fT4 30-45 pmol/L (upper limit of
normal 23 pmol/L), fT3 >8 pmol/L (upper limit 6.8 pmol/L with a normal
TSH, when chloral has been used for sedation prior to blood sampling,
Two of the children have subsequently had samples taken when sedated by
other methods (melatonin or pre ENT procedure) and have had euthyroid
results. They have no thyroid history and no medications known to affect
TFTs.
Is it an interference in the assay, displacement from binding proteins
or a physiological response? Would the TSH respond later (as in
overdoses) and suppress? Is there a risk to patients, or perhaps only
those with impaired cardiac function? What about patients on therapeutic
chloral (the doses here are about a third to a quarter of those for
sedation)?
Thanks in advance for your help
Caroline Jagger
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