Thyroidectomy for amiodarone-induced thyrotoxicosis
A. P. Farwell, S. L. Abend, S. K. Huang, N. A. Patwardhan and L. E. Braverman
Division of Endocrinology and Metabolism, University of Massachusetts Medical School, Worcester 01655.
Amiodarone hydrochloride, an iodine-rich drug used in the treatment of
tachyarrhythmias, is responsible for the development of thyrotoxicosis in
approximately 10% of patients who reside in areas of moderate iodine
deficiency. Treatment of amiodarone-induced thyrotoxicosis is difficult
since the drug has a prolonged half-life, cardiac decompensation due to
underlying heart disease occurs often, and discontinuation of amiodarone
therapy may not be possible. We report a patient with severe thyrotoxicosis
who received amiodarone for 34 months. Prolonged treatment with
methimazole, potassium perchlorate, iopanoic acid, and dexamethasone was
unsuccessful in controlling the hyperthyroid state. A near-total
thyroidectomy resulted in rapid amelioration of thyrotoxicosis. Since
surgery results in rapid control of thyrotoxicosis and permits continued
therapy with amiodarone, we suggest that near-total thyroidectomy warrants
consideration as definitive treatment for resistant amiodarone-induced
thyrotoxicosis.
Glucocorticoid Response in Amiodarone-Induced Thyrotoxicosis Resulting from Destructive Thyroiditis Is Predicted by Thyroid Volume and Serum Free Thyroid Hormone Concentrations
Bogazzi et al.
J. Clin. Endocrinol. Metab. 2007;92:556-562.
ABSTRACT
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Treatment of Type II Amiodarone-Induced Thyrotoxicosis by Either Iopanoic Acid or Glucocorticoids: A Prospective, Randomized Study
Bogazzi et al.
J. Clin. Endocrinol. Metab. 2003;88:1999-2002.
ABSTRACT
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Use of Oral Cholecystographic Agents in the Treatment of Amiodarone-Induced Hyperthyroidism
Chopra and Baber
J. Clin. Endocrinol. Metab. 2001;86:4707-4710.
ABSTRACT
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The Effects of Amiodarone on the Thyroid
Martino et al.
Endocr. Rev. 2001;22:240-254.
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Amiodarone-Induced Thyrotoxicosis
Daniels
J. Clin. Endocrinol. Metab. 2001;86:3-8.
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Amiodarone Induces Cytochrome c Release and Apoptosis through an Iodine-Independent Mechanism
Di Matola et al.
J. Clin. Endocrinol. Metab. 2000;85:4323-4330.
ABSTRACT
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Amiodarone and the thyroid: a practical guide to the management of thyroid dysfunction induced by amiodarone therapy
Newman et al.
Heart 1998;79:121-127.
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