Impact of thyroid metabolism on the course of INR levels in a patient with systemic anticoagulation suffering from amiodarone-induced thyrotoxicosis.
We report the case of a 60 year old female patient on continuous systemic anticoagulation therapy with coumarin due to mechanical aortic valve replacement and a more than 3 years lasting amiodarone therapy due to severe ventricular extrasystoles suffering from amiodarone induced thyrotoxicosis (AIT). During the course of AIT, showing different thyroid metabolic conditions, INR levels revealed a course closely related to the thyroid conditions indicating a significant and clear-cut effect of both hyper- and hypothyroidism on systemic anticoagulation therapy with coumarin. This continuous interaction of different thyroid metabolic conditions and the anticoagulation state could be well documented in the presented case over a time period of approximately five months.
Bucerius
J
J
Department of Nuclear Medicine, University of Bonn, Bonn, Germany. jan.bucerius@ukb.uni-bonn.de
Ezziddin
S
S
Brockmann
H
H
Palmedo
H
H
Biersack
H-J
HJ
D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D003374:Coumarins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008875:Middle Aged; D013961:Thyroid Gland / Q000378:metabolism*; D013971:Thyrotoxicosis / Q000097:blood / Q000139:chemically induced / Q000378:metabolism*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D018879:Ventricular Premature Complexes / Q000188:drug therapy* / Q000378:metabolism
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D003374:Coumarins; D014284:Triiodothyronine; D013972:Thyrotropin; C030123:coumarin; D000638:Amiodarone; D013974:Thyroxine