| Amiodarone-induced thyrotoxicosis in a patient with autonomously functioning nodular goiter. | |
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MedLine Citation:
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PMID: 19109209 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To report on adverse reactions associated with amiodarone and propylthiouracil. CASE SUMMARY: A 64-year-old female with atrial fibrillation and nodular goiter progressed to overt thyrotoxicosis after receiving therapy with amiodarone 200 mg/day for less than 12 weeks. Thyroid scan revealed a hyperfunctioning nodule in the left lobe, while immunologic studies were negative for both thyroid peroxidase and thyroglobulin antibodies. The thyroid-stimulating hormone (TSH) receptor antibody level was transiently elevated. Propylthiouracil 100 mg 3 times/day was started after the withdrawal of amiodarone, but the patient developed severe generalized skin rash, fever, and leukocytosis after 4 weeks. Thyroidectomy was performed, and histopathology was compatible with type 1 amiodarone-induced thyrotoxicosis (AIT) associated with toxic nodular goiter. An objective causality assessment revealed that thyrotoxicosis was probably related to use of amiodarone. DISCUSSION: Amiodarone is an antiarrhythmic agent that may cause thyroid dysfunction. Differentiating between the 2 types of AIT is important for implementation of the correct therapeutic strategy. The transient elevation of TSH receptor antibodies in AIT complicated the diagnosis. As a rare subtype, type 1 AIT by nodular goiter may be associated with early AIT. Initiating thyroid function monitoring within 3 months of amiodarone therapy should be considered. CONCLUSIONS: Type 1 AIT caused by nodular goiter is rarely reported. Amiodarone should be avoided in such patients and subtotal thyroidectomy to remove the toxic nodule may be the treatment of choice. |
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Authors:
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Yi-Lin Liang; Shih-Ming Huang; Shu-Ling Peng; Shu-Hwa Hsiao; Hao-Chang Hung; Horng-Yih Ou; Ta-Jen Wu |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2008-12-23 |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 43 ISSN: 1542-6270 ISO Abbreviation: Ann Pharmacother Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-05-01 Completed Date: 2010-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 134-8 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, National Cheng Kung University Hospital, Taiwan, Republic of China. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Amiodarone
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adverse effects* Anti-Arrhythmia Agents / adverse effects* Female Goiter, Nodular* / complications, diagnosis Humans Middle Aged Thyrotoxicosis / chemically induced*, diagnosis, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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