Clinical experience of amiodarone‐induced thyrotoxicosis over a 3‐year period: role of colour‐flow Doppler sonography*

Eaton, Simon; Euinton, H. A.; Newman, Christopher M.; Weetman, A. P.; Bennet, W. M.

doi:10.1046/j.0300-0664.2001.01457.x

Cited by 127 publications

(113 citation statements)

References 19 publications

(27 reference statements)

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“…A tool that is considered to be the best for rapid and early diagnosis of type 1 and 2 AIT is CFDS (19,20). This test determines the amount of blood flow within the thyroid and provides information about the morphology of the thyroid.…”

Section: Differentiating Between Type 1 and Type 2 Aitmentioning

confidence: 99%

“…This test determines the amount of blood flow within the thyroid and provides information about the morphology of the thyroid. Eighty per cent of patients can be classified as having type 1 or 2 AIT by CFDS (19,20). The four major patterns are described in Table 2.…”

Section: Differentiating Between Type 1 and Type 2 Aitmentioning

confidence: 99%

“…Overall, mild AIT resolves spontaneously in approximately 20% of cases (20). Type 1 AIT is treated with a thionamide because it is caused by increased hormonal synthesis (10).…”

Section: Treatment and Managementmentioning

confidence: 99%

“…Potassium perchlorate must be used with caution, because high doses are associated with aplastic anemia (20). It is recommended that daily doses be less than 1000 mg, or dosages be tapered or stopped after 30 days (21).…”

Section: Treatment and Managementmentioning

confidence: 99%

“…Type 2 AIT is treated with glucocorticoids for anti-inflammatory and membrane-stabilizing effects (20). Prednisone is started at 40 mg to 60 mg daily and tapered over two to three months.…”

Section: Treatment and Managementmentioning

confidence: 99%

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Amiodarone-induced thyrotoxicosis: A review

Tsang

Houlden

2009

Canadian Journal of Cardiology

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Section: Differentiating Between Type 1 and Type 2 Aitmentioning

confidence: 99%

Section: Differentiating Between Type 1 and Type 2 Aitmentioning

confidence: 99%

“…Overall, mild AIT resolves spontaneously in approximately 20% of cases (20). Type 1 AIT is treated with a thionamide because it is caused by increased hormonal synthesis (10).…”

Section: Treatment and Managementmentioning

confidence: 99%

Section: Treatment and Managementmentioning

confidence: 99%

“…Type 2 AIT is treated with glucocorticoids for anti-inflammatory and membrane-stabilizing effects (20). Prednisone is started at 40 mg to 60 mg daily and tapered over two to three months.…”

Section: Treatment and Managementmentioning

confidence: 99%

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Amiodarone-induced thyrotoxicosis: A review

Tsang

Houlden

2009

Canadian Journal of Cardiology

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Amiodarone‐Induced Thyrotoxicosis

Bogazzi¹,

Tomisti²,

Bartalena³

et al. 2018

Endocrine and Metabolic Medical Emergencies

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miodarone, an effective iodine-rich antiarrhythmic drug, frequently causes either changes in thyroid function tests or clinical thyroid dysfunction. Both amiodarone-induced thyrotoxicosis (AIT) and amiodarone-induced hypothyroidism (AIH) have an overall incidence of approximately 14-18%, and AIT being most common in iodinedeficient areas, AIH in iodine-sufficient areas. Both dysfunctions may develop either in apparently normal thyroid glands or in glands with preexisting abnormalities (either nodular goiter or thyroid autoimmune disease). The most important pathogenic mechanisms of AIT include excess iodine-induced thyroid hormone synthesis (type I AIT) and amiodarone (or iodine)related destructive thyroiditis (type II AIT), but mixed forms involving both pathogenic mechanisms are likely more frequent than previously believed. AIT is a therapeutic challenge, because rapid restoration of euthyroidism is warranted in patients with underlying cardiac disorders. Treatment of choice for type I AIT is represented by the concomitant administration of thionamides and potassium perchlorate, whereas steroids are the most useful tool for type II AIT. Mixed (or, better, undefined) forms of AIT should be treated with a combination of thionamides, potassium perchlorate and glucocorticoids. Radioiodine therapy is usually not feasible owing to low thyroidal radioiodine uptake due to iodine load, while thyroidectomy can be performed in cases resistant to medical therapy or in those patients requiring a rapid control of thyrotoxicosis after a short course with iopanoic acid to restore normal serum T3 levels. Thyroid ablation is usually required in type I and undefined AIT, also because this allows safe reinstitution of amiodarone treatment, if needed; follow-up without treatment is sufficient in most patients with type II AIT, who usually remain euthyroid or may develop hypothyroidism after reexposure to iodine load.

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