Amiodarone-induced hypothyroidism with EPO-resistant anemia in a patient with chronic renal failure.
The overall incidence of amiodarone-induced thyroid dysfunction ranges from 2% to 24%. One third to half of patients with hypothyroidism have anemia due to some decrease in normal red blood cell mass and erythropoietin (EPO) resistance. Therefore, for patients with chronic renal disease under medication with amiodarone, early regular thyroid function test should be checked in order to avoid amiodarone-induced hypothyroidism and EPO-resistant anemia. If amiodarone-induced hypothyroidism and EPO-resistant anemia occur in patients with chronic renal failure, early thyroxine should be given instead of waiting for spontaneous recovery by amiodarone discontinuation only. Here, we report a patient with chronic renal failure who developed EPO-resistant anemia after amiodarone treatment for arrhythmia. The hemoglobin level responded to EPO therapy rapidly after thyroxine administration and amiodarone discontinuation.
Chang
Peter M S
PM
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Ng
Yee-Yung
YY
D000369:Aged, 80 and over; D000638:Amiodarone / Q000009:adverse effects*; D000740:Anemia / Q000188:drug therapy*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D004351:Drug Resistance; D004921:Erythropoietin / Q000627:therapeutic use*; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male
D000889:Anti-Arrhythmia Agents; D004921:Erythropoietin; D000638:Amiodarone