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Amiodarone-induced thyrotoxicosis: a review Tsang W; Houlden RLCan J Cardiol 2009[Jul]; 25 (7): 421-4BACKGROUND: Amiodarone-induced thyrotoxicosis (AIT) develops in 3% of amiodarone-treated patients in North America. AIT is classified as type 1 or type 2. Type 1 AIT occurs in patients with underlying thyroid pathology such as autonomous nodular goiter or Graves' disease. Type 2 AIT is a result of amiodarone causing a subacute thyroiditis with release of preformed thyroid hormones into the circulation. OBJECTIVES: To review the literature and present an overview of the differentiation between and management of type 1 and type 2 AIT. METHODS: PubMed, the Cumulative Index to Nursing and Allied Health Literature and Medscape searches of all available English language articles from 1983 to 2006 were performed. Search terms included 'amiodarone -induced thyrotoxicosis', 'complications', 'management', 'treatment' and 'colour flow Dopper sonography'. RESULTS: There is evidence to suggest that to differentiate between type 1 and type 2 AIT, a careful history and physical examination should be performed to identify pre-existing thyroid disease. An iodine-131 uptake test and colour flow Doppler sonography should be performed. Patients with type 2 AIT should receive a trial of glucocorticoids, whereas those with type 1 should receive antithyroid therapy. For patients in whom the mechanism of the thyrotoxicosis is unclear, a combination of prednisone and antithyroid therapy may be considered.|Amiodarone/*adverse effects[MESH]|Anti-Arrhythmia Agents/*adverse effects[MESH]|Goiter, Nodular/complications[MESH]|Graves Disease/complications[MESH]|Humans[MESH]|Thyroiditis, Subacute/complications[MESH]|Thyrotoxicosis/*chemically induced/classification/diagnosis/etiology[MESH]|Vasodilator Agents/*adverse effects[MESH] |
