Surgical management of amiodarone-induced thyrotoxicosis in a patient with Eisenmenger's syndrome: literature review and case report.
OBJECTIVE
We present a patient with a rare combination of amiodarone-induced thyrotoxicosis and Eisenmenger's syndrome.


METHODS
Case report and review of the world literature regarding the morbidity and mortality of surgical management of amiodarone-induced thyrotoxicosis and the potential hazards of non-cardiac surgery in patients with Eisenmenger's syndrome.


RESULTS
Failure of maximal medical therapy necessitated surgical management to treat amiodarone-induced thyrotoxicosis which, in this particular patient, carried significant risks. Total thyroidectomy was performed leading to rapid resolution of thyrotoxicosis, and the patient made an uncomplicated recovery. We present this case because of its rarity and the potentially hazardous nature of surgical intervention in patients with Eisenmenger's syndrome. The pathogenesis of amiodarone-induced thyrotoxicosis and the differing approaches of medical and surgical management are discussed.


CONCLUSIONS
Based on our findings, we propose that surgical management should be considered earlier in the treatment algorithm (or possibly as first-line therapy) for amiodarone-induced thyrotoxicosis.
Pratap
R
R
Department of Otolaryngology, Norfolk and Norwich University Hospital, Cambridge, UK.
Qayyum
A
A
Ahmad
N
N
Jani
P
P
D000328:Adult; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D004541:Eisenmenger Complex / Q000150:complications*; D006801:Humans; D008297:Male; D012307:Risk Factors; D013965:Thyroidectomy / Q000379:methods; D013971:Thyrotoxicosis / Q000139:chemically induced / Q000601:surgery*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone