Thyroidectomy for amiodarone-induced thyrotoxicosis

Article Abstract:

Amiodarone hydrocholoride is a drug that is rich in iodine, and is frequently used in treating tachyrhythmia, a condition of dangerously rapid heartbeats. A side effect of treatment with this drug is thyrotoxicosis, or hyperthyroidism, excessive secretion of thyroid hormones. Because the arrhythmia treated is often life-threatening, and amiodarone is effective for this condition where other drugs are not, discontinuation is usually not considered. Of the patients who receive this drug on a long-term basis, about 10 percent develop thyrotoxicosis. Treatment of this side effect is difficult because of the long half-life (the time it takes to eliminate one half the dose) of amiodarone, which is fat soluble. A case history is reported of a 54-year-old man who received amiodarone for 34 months to treat a serious ventricular arrhythmia. The patient developed severe thyrotoxicosis. After clinical evaluation and review of the results of diagnostic tests, the patient was treated without success with a series of drugs, including methimazole, potassium perchlorate, and dexamethasone. Surgery was then performed that involved the removal of almost the entire thyroid gland (thyroidectomy); levothyroxine was given to control the postoperative hypothyroidism and amiodarone therapy was resumed. Within 11 months the patient was without symptoms of arrhythmia or thyroid irregularities. In most cases of thyrotoxicosis resulting from iodine, effective treatment can be achieved by drug therapy and surgery is not normally warranted. However, thyroidectomy may be the best alternative in patients with cardiac complications. When thyrotoxicosis results from amiodarone treatment that cannot safely be discontinued, thyroidectomy may be the best solution. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Complications and side effects, Amiodarone, Vasodilators, Vasodilator agents, Thyroidectomy

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Treatment guidelines for patients with hyperthyroidism and hypothyroidism

Article Abstract:

The American Thyroid Association has established treatment guidelines to aid physicians in their management of patients with hyperthyroidism or hypothyroidism. Hyperthyroidism is a condition of excess levels of thyroid hormones in the blood, commonly caused by Graves' disease. Patients may experience nervousness or irritability, fatigue, shortness of breath, weight loss and other disturbances of bodily functions. Diagnosis should include careful medical history taking, physical examination and laboratory tests to measure thyroid hormone levels. Therapy may include antithyroid drugs, radioactive iodine or surgery to remove the thyroid gland. Hypothyroidism is caused when a thyroid disorder leads to inadequate production of thyroid hormone. Patients may be tired or weak, intolerant to cold, and have dry skin. The main treatment for hypothyroidism is levothyroxine sodium therapy. Patients with either hyperthyroidism or hypothyroidism should be monitored on a continuing basis. Treatment of special problems is also discussed.

Hypothyroidism

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Thyroiditis

Article Abstract:

The diagnosis and treatment of thyroiditis are reviewed. Thyroiditis is an inflammation of the thyroid gland. Topics include autoimmune, clinical, and biochemical changes in thyroiditis, terminology, Hashimoto's thyroiditis, painless postpartum thyroiditis, painless sporadic thyroiditis, painful subacute thyroiditis, suppurative thyroiditis, drug-induced thyroiditis, and Reidel's thyroiditis.

Diagnosis, Physiological aspects, Thyroiditis

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