title: [Thyroid dysfunction and amiodarone].
abstract: Although most patients remain clinically euthyroid, some develop amiodarone-induced hyperthyroidism (HPEAI) or hypothyroidism (HPOAI). The authors present a retrospective analysis of ten patients with amiodarone-induced thyroid dysfunction. Six patients were female and mean amiodarone intake was 17.7 months. HPOIA was more common (six patients). From all the patients with HPEAI, two had type 2, one had type 1, and one had type 3 hyperthyroidism. Symptoms suggestive of thyroid dysfunction occurred in five patients, most of them with HPOAI. In HPEAI, the most frequent symptom was exacerbation of arrhythmia (three patients). Discontinuation of amiodarone and treatment with levothyroxine was chosen in 83.3% of the HPOAI cases, while thyonamide treatment with corticosteroids and without amiodarone was the option in 75% of the HPEAI cases. There were three deaths, all in patients with HPEAI. HPEAI is potentially fatal. The clinical picture may be vague, so the thyroid monitoring is mandatory.
authors: Serviço de Medicina Interna dos Hospitais de Universidade de Coimbra, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal. limajandira@gmail.com
authors: Jandira
authors: J
authors: Lima
authors: Patrícia
authors: P
authors: Carvalho
authors: M Auxiliadora
authors: MA
authors: Molina
authors: Marta
authors: M
authors: Rebelo
authors: Patrícia
authors: P
authors: Dias
authors: José Diniz
authors: JD
authors: Vieira
authors: José M Nascimento
authors: JM
authors: Costa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D013956:Antithyroid Agents / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced* / Q000188:drug therapy; D007037:Hypothyroidism / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D008713:Methimazole / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D000889:Anti-Arrhythmia Agents; D013956:Antithyroid Agents; D004338:Drug Combinations; D005938:Glucocorticoids; D008713:Methimazole; D000638:Amiodarone; D013974:Thyroxine