Use of oral cholecystographic agents in the treatment of amiodarone-induced hyperthyroidism.
We describe here five cardiac patients with type II amiodarone-induced hyperthyroidism who were treated prospectively with a combination of an oral cholecystographic agent (sodium ipodate, Oragrafin, or sodium iopanoate, Telepaque) and a thionamide (propylthiouracil or methimazole); amiodarone was discontinued in all patients. All patients improved substantially clinically within a few days of treatment and became euthyroid or hypothyroid in 15-31 wk when treatment was discontinued. Four of the five became hypothyroid and required long-term treatment with L-T(4); the remaining patient was euthyroid, but died from cardiomyopathy and congestive heart failure at 29 wk, when he had been off oral cholecystographic agent and thionamide for 6 wk. We did not find any clinical or biochemical adverse effects of the treatment. Our study suggests that a combination of oral cholecystographic agent and thionamide is a safe and effective treatment of type II amiodarone-induced hyperthyroidism. Data also suggest that hypothyroidism is a common end result of type II amiodarone-induced hyperthyroidism.
Chopra
I J
IJ
Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, University of California Center for Health Sciences, 900 Veteran Avenue, Los Angeles, CA 90024, USA. ichopra@mednet.ucla.edu
Baber
K
K
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D013956:Antithyroid Agents / Q000008:administration & dosage*; D002765:Cholecystography; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D007453:Iodide Peroxidase / Q000037:antagonists & inhibitors*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000889:Anti-Arrhythmia Agents; D013956:Antithyroid Agents; D004791:Enzyme Inhibitors; D007453:Iodide Peroxidase; D000638:Amiodarone