García-Sáenz M, Espinosa-Cárdenas E

Language: Spanish
References: 23
Page: 24-29
PDF size: 194.97 Kb.

ABSTRACT

Amiodarone induced thyrotoxicosis (AIT) appears on the 5-12% of patients, it potentially can exacerbate a cardiac illness, leading to an increase in the morbility/mortality of patients. Two types of AIT exist, each one with a different etiology. It is important to distinguish between them to be able to establish a treatment. However, sometimes it can be quite difficult.
Case Report: An 81 year-old woman, with a history of acute myelod leukemia, showed up with thyroid enlargement at the ER. She was discharged 48 h earlier, after an atrial fibrillation (AF) episode which was controlled with amiodarone IV infusion. Because the biochemical diagnosis of thyrotoxicosis and reaparition of AF,an AIT was suspected.
To be able of distinguishing between the two types of AIT is essential to establish a treatment. The use of a thyroid doppler sonography and a thyroid scintigraphy is helpful. The comorbidities of the patient and the possible side effects should be taken into account when deciding the treatment

REFERENCES

1. Bogazzi F, Bartalena L, Martino E. Approach to the patient with Amiodarone-Induced yrotoxicosis. J Clin Endocrinol Metab. 2010;95:2529-35.

2. Winter-Tavares AB, Kalil de Paula S, Vaisman M, et al. Amiodarone and yrotoxicosis: Case Reports. Arq Bras Cardiol. 2010;95(5):e122-e124.

3. Basaria S, Cooper DS. Amiodarone and the thyroid. Am J Med. 2005;118(7):706-14.

4. Zipes DP, Prystowsky EN, Heger JJ. Amiodarone: electrophysiologic actions, pharmacokinetics and clinical effects. Journal of the American College of Cardiology. 1984; 4(4):1059-71.

5. Danzi S, Klein I. Amiodarone-Induced yroid Dysfunction. Journal of Intensive Care Medicine. 2015;30(4):179-85.

6. Tsang W, Houlden R. Amiodarone-induced thyrotoxicosis: A review. 2009;25(7):421-5.

7. Vara Luiz H, Mnita I, Portugal J. yroiditis. En Imam SK, Ahmad SI (eds). yroid Disorders: Basic Science and Clinical Practice. Swetzerland: Springer; 2016. p.p. 96-7.

8. Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med. 2004;164:1675-8.

9. Roa RH. Iodine kinetic studies during amiodarone treatment. J Clin Endocrinol Metab. 1986;62:563-8.

10. Pollak PT, Bouillon T, Shafer SL. Population pharmacokinetics of long-term oral amiodarone therapy. Clin Pharmacol er. 2000;67:642-52.

11. Martino E, Bartalena L, Bogazzi F, et al. e effects of amiodarone on the thyroid. Endocr Rev. 2001;22(2):240-54.

12. Pavan R, Jesus AMX, Maciel LMZ. A amiodarone e a tireóide. Arq Bras Endocrinol Metab. 2004;48(1):176-81.

13. Schaan BD, Cunha CP, Francisconi A, et al. Amiodarone-induced thyroid dysfunction in a tertiary center in South Brazil. Arq Bras Endocrinol Metab. 49(6):916-22.

14. Van Beeren HC, Kwakkel J, Ackermans MT, et al. Action of specific thyroid hormone receptor a(1) and b(1) antagonists in the central and peripheral regulation of thyroid hormone metabolism in the rat. yroid. 2012;22(12):1275-82.

15. Piga M, Serra A, Boi F, et al. Amiodarone-induced thyrotoxicosis. A review. Minverva Endocrinol. 2008;33(3):213-28.

16. Meller J, Becker W. e continuing importance of thyroid scintigraphy in the era of high-resolution ultrasound. European Journal of Nuclear Medicine and molecular Imaging. 2002;29(2):S425-S438.

17. Piga M, Cocco MC, Serra A, et al. e usefulness of 99 mTc-sestaMIBI thyroid scan in the differential diagnosis and management of amiodarone-induced thyrotoxicosis. European Journal of Endocrinology. 2008;159:423-9.

18. Wong R, Cheung W, Stockigt JR, et al. Heterogeneity of amiodarone-induced thyrotoxicosis: evaluation of colour- flow Doppler sonography in predicting therapeutic response. Internal Medicine Journal. 2003;33:420-6.

19. Bogazzi F, Martino E, Dell’Unto E, et al. yroid color flow doppler sonography and radioiodine uptake in 55 consecutive patients with amiodarone-induced thyrotoxicosis. J Endocrinol Invest. 2003;36(7):635-40.

20. Bogazzi F, Bartalena L, Tomisti L, et al. Glucocorticoid response in amiodarone-induced thyrotoxicosis resulting from destructive thyroiditis is predicted by thyroid volume and serum free thyroid hormone concentrations. J Clin Endocrinol Metab. 2007;92:556-62.

21. Uzan L, Guignat L, Meune C, et al. Continuation of amiodare therapy despite type II amiodarone-induced thyrotoxicosis. Drug Saf. 2006;29:231-6.

22. Bogazzi F, Bartalena L, Tomisti L, et al. Continuation of Amiodarone Delays Restoration of Euthyroidism in Patients with Type 2 Amiodarone-Induced yrotoxicosis Treated with Prednisone: A Pilot Study. J Clin Endocrinol Metab. 2011;96(11):3374-80.

23. Vilchez López FJ, Mateo Gavira I, Gavilan Villarrejo I, et al. Tiroiditis. Medicine. 2012;11(14); 27-35.