Document Detail


Thyroid dysfunction during chronic amiodarone therapy.
MedLine Citation:
PMID:  3794094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinical and laboratory features of 99 patients receiving long-term amiodarone therapy were analyzed to determine which individuals may be at a high risk for developing amiodarone-induced thyroid dysfunction. The group of 68 men and 31 women was followed up for an average of 27 months (range 3 to 60). There were no differences in age, sex, dose of amiodarone, type or severity of underlying heart disease or baseline serum thyroxine levels in patients who developed hypothyroidism (n = 32) or hyperthyroidism (n = 5) or remained euthyroid (n = 62). Baseline serum thyrotropin levels were statistically higher in patients who became hypothyroid, but there was considerable overlap with the other patient groups. Serum reverse triiodothyronine (reverse T3), which has been suggested to be a marker of amiodarone efficacy, correlated directly with serum thyroxine levels, and was not an independent variable. There was no pattern to the time course for development of thyroid dysfunction, which occurred in 49% of those followed up and developed as early as 1 month or, in one individual, as late as after 3 years of amiodarone therapy. There are few guidelines for replacement therapy in patients with amiodarone-induced hypothyroidism. L-thyroxine dosage was adjusted cautiously in these high risk individuals to achieve serum thyroxine levels within the reference range of euthyroid individuals taking amiodarone: the mean dosage required was 136 micrograms/day. Normalization of serum thyrotropin (TSH) would have required doses of L-thyroxine that were judged to be excessively high.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S G Albert; L E Alves; E P Rose
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  9     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1987 Jan 
Date Detail:
Created Date:  1987-02-02     Completed Date:  1987-02-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  175-83     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Amiodarone / adverse effects*,  therapeutic use
Arrhythmias, Cardiac / drug therapy
Cholesterol / blood
Female
Humans
Hyperthyroidism / chemically induced*
Hypothyroidism / chemically induced*
Male
Risk
Thyroid Function Tests
Thyrotropin / blood
Thyroxine / blood
Chemical
Reg. No./Substance:
1951-25-3/Amiodarone; 57-88-5/Cholesterol; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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