A case of amiodarone-induced hypothyroidism in a mild to moderate iodine deficiency area

Autori

  • Roberto Vita University of Messina,  Department of Clinical and Experimental Medicine
  • Salvatore Benvenga University of Messina,  Department of Clinical and Experimental Medicine

DOI:

https://doi.org/10.6092/1828-6550/APMB.105.2.2017.A6

Parole chiave:

amiodarone, hypothyroidism, iodine

Abstract

Thyroid dysfunction associated to amiodarone treatment depends on iodine intake, as thyrotoxicosis occurs more frequently in iodine deficiency areas, whereas hypothyroidism in iodine sufficient areas. We present here a case of severe overt hypothyroidism induced by prolonged treatment with amiodarone for atrial fibrillation in a man living in a low iodine intake area. The case was managed with levothyroxine (LT4) replacement and amiodarone withdrawal. Euthyroidism was restored after two months, and atrial fibrillation has not relapsed to date.

Riferimenti bibliografici

Singh B.N. (2008) Amiodarone as paradigm for developing new drugs for atrial fibrillation. J Cardiovas Pharmacol, 52 (4), 300-305.

Basaria, S., Cooper, D.S. (2005) Amiodarone and the thyroid. Am J Med, 118 (7), 706-714.

Narayana, S.K., Woods, D.R., Boos, C.J. (2011) Management of amiodarone-related thyroid problems. TherAdvEndocrinolMetab, 2 (3), 115-126.

Vassallo, P., Trohman, R.G. (2007) Prescribing amiodarone: an evidence-based review of clinical indications. JAMA, 298 (11), 1312-1322.

Siniakowicz, R.M., Narula, D., Suster, B., Steinberg, J.S. (2001) Diagnosis of amiodarone pulmonary toxicity with high-resolution computerized tomographic scan. J CardiovascElectrophysiol, 12 (4), 431-436.

Figge, J., Dluhy, R.G. (1990) Amiodarone-induced elevation of thyroid stimulating hormone in patients receiving levothyroxine for primary hypothyroidism. Ann In Med, 113 (7), 553-555.

Chiovato, L., Martino, E., Tonacchera, M., Santini, F., Lapi, P., Mammoli, C. et al (1994) Studies on the in vitro cytotoxic effect of amiodarone. Endocrinology, 134 (5), 2277-2282.

Trip, M.D., Wiersinga, W., Plomp, T.A. (1991) Incidence, predictability, and pathogenesis of amiodarone-induced thyrotoxicosis and hypothyroidism. Am J Med, 91 (5), 507-511.

Martino, E., Safran, M., Aghini-Lombardi, F., Rajatanavin, R., Lenziardi, M., Fay, M. et al (1984) Environmental iodine intake and thyroid dysfunction during chronic amiodarone therapy. Ann Int Med, 101 (1), 28-34.

Batcher, E.L., Tang, X.C., Singh, B.N., Singh, S.N., Reda, D.J., Hershman, J.M. et al (2007) Thyroid function abnormalities during amiodarone therapy for persistent atrial fibrillation. Am J Med, 120 (10), 880-885.

Trifanescu, R., Fica, S., Barbu, C., Vartej, I., Ursu, H., Bunghez, R., et al (2004) Amiodarone-induced thyroid dysfunction in cardiac patients from areas with iodine deficiency. Rom J Int Med, 42 (3), 595-605.

Loh, K. (2000) Amiodarone-induced thyroid disorders: a clinical review Postgraduate Medical Journal, 76, 133-140

Martino, E., Aghini-Lombardi, F., Mariotti, S., Bartalena, L., Lenziardi, M., Ceccarelli, C. et al.(1987) Amiodarone iodine-induced hypothyroidism: risk factors and follow-up in 28 cases. ClinEndocrinol (Oxf), 26 (2), 227-237.

Martino, E., Bartalena, L., Mariotti S., Aghini-Lombardi, F., Ceccarelli, C., Lippi F et al. (1998) Radioactive iodine thyroid uptake in patients with amiodarone-iodine-induced thyroid dysfunction. Acta Endocrinol, 119, 167-173.

Bogazzi, F., Tomisti, L., Bartalena, L., Aghini-Lombardi, F., Martino, E. (2012) Amiodarone and the thyroid: a 2012 update. J Endocrinol Invest, 35, 340-348.

Pazin-Filho, A., de Jesus, A.M., Magalhaes, P.K., Melato, L.H., Campos, D., Maciel, B.C. et al (2009) How frequently should a patient taking amiodarone be screened for thyroid dysfunction? Braz J MedBiol Res, 42 (8), 744-749.

Bogazzi, F., Bartalena, L., Tomisti, L., Dell'Unto, E., Cosci, C., Sardella, C. et al (2008). Potassium perchlorate only temporarily restores euthyroidism in patients with amiodarone-induced hypothyroidism who continue amiodarone therapy. J Endocrinol Invest 31:515-519.

Dowloads

Pubblicato

2017-12-21

Fascicolo

V. 105 N. 2 (2017)

Sezione

CLINICAL CASE SEMINAR

Licenza

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:
  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).