Anesthetic Considerations in a Patient with Amiodarone-Induced Thyrotoxicosis

Calis, Paul; Berendsen, Remco R.; Logeman, Angelique; Sarton, Elise; Aarts, Leon

doi:10.1155/2010/984981

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…[13] Thionamides, usually with a short course of potassium per chlorate are beneficial, and if no response we can add steroids but the effect of medical therapy may take as long as 4 months to be efficient. [7] Major anti-thyroid drugs are able to temporary control symptoms but all are hepatotoxic especially that treatment requires high doses, steroids can reduce the inflammation but have major side effects, plasmpharesis can provide acute relief of type 2 amiodarone induced thyrotoxicosis but its effect is transient, with higher cost and impossibility of long term use. Radioactive iodine is not feasible in all conditions especially in type 2 because of a low uptake.…”

Section: Discussionmentioning

confidence: 99%

Surgery in Refractory Amiodarone-Induced Thyrotoxicosis

Richa¹,

Rawas²

2018

JED

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Background: Thyroidectomy is a challenging treatment for refractory amiodarone induced thyrotoxicosis (AIT). Objectives: The authors' aim in this article is to conduct a systematic review of the currently available literature regarding thyroidectomy for the treatment of refractory AIT. Methods: The authors' systematic review yielded 14 studies encompassing 39 patients. Results: All patients in this study developed thyrotoxicosis on amiodarone especially those with cardiac fragility and benefit from thyroidectomy to control all the symptoms of the hyperthyroid state without surgical risk or consequence on the cardiac status. Conclusion: Thyroidectomy remains the definitive management of refractory AIT and should be instituted sooner rather than later in a patient suffering from this condition.

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Section: Discussionmentioning

confidence: 99%

Surgery in Refractory Amiodarone-Induced Thyrotoxicosis

Richa¹,

Rawas²

2018

JED

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“…Due to its capability to promptly restore euthyroidism, salvage thyroidectomy can be considered the treatment of choice for those patients presenting with a thyrotoxicosis-driven rapid deterioration of cardiac function and/or malignant arrhythmias. As anesthetic and surgical risks may remain quite high in this setting [ 59 ], a careful risk-to-benefit evaluation should be performed in the individual patient [ 60 , 61 ]. It seems agreeable to have surgery performed by skilled surgeons and only when a multidisciplinary team is available [ 17 , 53 , 54 , 62 , 63 ].…”

Section: Novel Concepts Emerging In Ait Therapymentioning

confidence: 99%

Short review: novel concepts in the approach to patients with amiodarone-induced thyrotoxicosis

Cappellani,

Bartalena,

Bogazzi

2023

J Endocrinol Invest

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Introduction Amiodarone-induced thyrotoxicosis is associated with high morbidity and mortality rates. The approach to this condition is widely variable across different medical specialists and even among expert endocrinologists. As a matter of fact, the approach to amiodarone-induced thyrotoxicosis has always been considered difficult, due to diagnostic uncertainties easily resulting in missteps, and therapeutic challenges easily resulting in unresponsiveness or slow-responsiveness to the administered drugs. Purpose Our purpose is to review novelties emerged during the last years about this condition, with the aim to provide novel insights on the diagnostic and therapeutic management of this challenging condition.

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“…[21][22][23][24] Anesthetic considerations include meticulous control of blood pressure, heart rate, temperature with awareness of early recognition and treatment of thyroid storm and arrhythmias. 25,26 A large majority of the published cases were performed under general anesthesia, and only few case reports under regional and local anesthesia were described. 27,28 Close collaboration between endocrinologists, cardiologists, endocrine surgeons and anesthesiologists is essential to complete thyroidectomy successfully.…”

Section: Wjoesmentioning

confidence: 99%

Refractory Amiodarone-induced Thyrotoxicosis: The Surgical Option

Ishay¹,

Carmeli²,

Rozner³

et al. 2013

World Journal of Endocrine Surgery

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Amiodarone-induced thyrotoxicosis is often poorly tolerated owing to underlying cardiac disease, and frequently resistant to medical therapy. We describe a 48-year-old patient with severe cardiac disease who developed amiodarone-associated thyrotoxicosis, refractory to standard medical therapy. Due to the unremitting thyrotoxicosis, a total thyroidectomy was performed without complications resulting in rapid correction of the thyrotoxicosis and enabling resumption of amiodarone therapy. Despite the concerns inherent to severe cardiac disease, total thyroidectomy can be performed safely in patients with resistant amiodarone-induced thyrotoxicosis. We believe that surgery should be considered early in the treatment planning. How to cite this article Ishay A, Carmeli J, Rozner E, Luboshitzky R. Refractory Amiodarone-induced Thyrotoxicosis: The Surgical Option. World J Endoc Surg 2013;5(1):21-24.

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Anesthetic Considerations in a Patient with Amiodarone-Induced Thyrotoxicosis

Cited by 6 publications

References 14 publications

Surgery in Refractory Amiodarone-Induced Thyrotoxicosis

Surgery in Refractory Amiodarone-Induced Thyrotoxicosis

Short review: novel concepts in the approach to patients with amiodarone-induced thyrotoxicosis

Refractory Amiodarone-induced Thyrotoxicosis: The Surgical Option

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