title: Amiodarone-Induced Thyrotoxicosis Recurrence After Amiodarone Reintroduction.
abstract: Reintroduction of amiodarone in patients with a history of amiodarone-induced thyrotoxicosis (AIT) is rarely used. To date, the risk of AIT recurrence after amiodarone reintroduction is unpredicted. The aim of the study was to evaluate the risk of AIT recurrence. Retrospectively, from 2000 to 2011, all euthyroid patients with a history of AIT with amiodarone reintroduction were included. Type and severity of the first AIT, amiodarone chronology, and thyroid function evolution after reintroduction of amiodarone were investigated: 46 of 172 patients with AIT history needed amiodarone reintroduction. At first AIT episode, the mean age was 62.2 ± 16 years with male gender predominance; 65% of patients were classified as type 1 AIT. AIT recurred in 14 patients (30%), 12 patients developed hypothyroidism (26%), and 20 patients remained euthyroid (44%). Characteristics of type 1 AIT during the first episode, namely briefer exposure period to amiodarone and longer duration of treatment to normalize thyroid hormones, were predictive of AIT recurrence; 73% of patients (8 of 11) with previous episode of type 1 AIT, who did not receive a preventive thioamide treatment, developed a second episode of AIT. Thioamide preventive treatment could be useful to prevent type 1 AIT recurrence. In conclusion, AIT recurrence after amiodarone reintroduction is 4 times more frequent in patients with type 1 AIT history. Thyroid ablation before amiodarone reintroduction in patients with a history of type 1 AIT is preferred. Preventive thioamide treatment could be suggested in patients with type 1 AIT history pending for surgery.
authors: Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France; UMR CNRS 6293, INSERM U1103, Génétique Reproduction et Développement, Université Clermont-Auvergne, Aubiere, France. Electronic address: smaqdasy@chu-clermontferrand.fr.
authors: Salwan
authors: S
authors: Maqdasy
authors: Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France; UMR CNRS 6293, INSERM U1103, Génétique Reproduction et Développement, Université Clermont-Auvergne, Aubiere, France.
authors: Marie
authors: M
authors: Batisse-Lignier
authors: Service de Santé Publique, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors: Candy
authors: C
authors: Auclair
authors: Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors: Françoise
authors: F
authors: Desbiez
authors: Service de cardiologie et maladies cardiovasculaires, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors: Bernard
authors: B
authors: Citron
authors: Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors: Philippe
authors: P
authors: Thieblot
authors: Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors: Béatrice
authors: B
authors: Roche
authors: Service de cardiologie et maladies cardiovasculaires, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors: Jean René
authors: JR
authors: Lusson
authors: Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France; UMR CNRS 6293, INSERM U1103, Génétique Reproduction et Développement, Université Clermont-Auvergne, Aubiere, France.
authors: Igor
authors: I
authors: Tauveron
mesh_terms: D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013971:Thyrotoxicosis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone