title: Amiodarone-induced thyrotoxicosis in a case of Eisenmenger's syndrome.
abstract: Eisenmenger's syndrome is a condition due to any congenital heart defect with an intracardiac left-to-right communication that leads to pulmonary hypertension with reversed right-to-left blood flow and secondary cyanosis. The main complications of Eisenmenger's syndrome are heart failure and arrhythmias. Amiodarone, the drug of choice for arrhythmia treatment in such patients, can cause a number of complications, including amiodarone induced thyrotoxicosis (AIT). Hereby, we present a 41-year-old patient with Eisenmenger's syndrome who developed AIT and was successfully treated with radioactive iodine therapy. The patient had an accompanying heart failure and had been treated with amiodarone due to chronic atrial fibrillation. Twenty months later he developed an AIT for which was treated with 814 MBq (22 mCi) radioactive iodine. Since 7 weeks later only a slight decline in thyroid hormones was observed, the patient was received a transient treatment with methimazole, which had to be withdrawn soon due to severe leucopenia. Because of the need to maintain amiodarone, a second ablative radioactive iodine dose was administered leading to complete clinical remission. In conclusion, this case demonstrates that even though amiodarone reduces iodine uptake to a very low level, the therapy with radioactive iodine can be still effective if it is given in a repeated dose to patients who require continuation of amiodarone.
authors: Department of Endocrinology, Metabolism and Internal Diseases, University of Medical Sciences in Poznan, Poland. agata.rat@wp.pl.
authors: Agata
authors: A
authors: Czarnywojtek
authors: Department of Endocrinology, Metabolism and Internal Diseases, University of Medical Sciences in Poznan, Poland.
authors: Kosma
authors: K
authors: Woliński
authors: Department of Endocrinology, Metabolism and Internal Diseases, University of Medical Sciences in Poznan, Poland.
authors: Ryszard
authors: R
authors: Waśko
authors: Laboratory of Environmental Research, Department of Toxicology, Poznan University of Medical Sciences, Poland.
authors: Ewa
authors: E
authors: Florek
authors: Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Poznan University of Medical Sciences, Poland.
authors: Małgorzata
authors: M
authors: Zgorzalewicz-Stachowiak
authors: Department of Endocrinology, Metabolism and Internal Diseases, University of Medical Sciences in Poznan, Poland.
authors: Marta
authors: M
authors: Fichna
authors: Department of Invasive Cardiology, District Hospital, Poznan, Poland.
authors: Weronika
authors: W
authors: Greberska
authors: Department of Cardiology - Intensive Therapy and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
authors: Przemysław
authors: P
authors: Guzik
authors: Medical Sociology Department, Loyola University, Chicago, USA.
authors: Martha
authors: M
authors: Lodyga
authors: Medical Student at Poznan University of Medical Sciences, Poznan, Poland.
authors: Barbara
authors: B
authors: Kwiecinska
authors: Department of Endocrinology, Metabolism and Internal Diseases, University of Medical Sciences in Poznan, Poland.
authors: Marek
authors: M
authors: Ruchała
mesh_terms: D000328:Adult; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D004541:Eisenmenger Complex / Q000188:drug therapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D013971:Thyrotoxicosis / Q000139:chemically induced* / Q000532:radiotherapy; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D007457:Iodine Radioisotopes; D000638:Amiodarone