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Cited by 49Thyroid Disorders and TreatmentsOphthalmology and Eye DisordersAdrenal Hormones and Disorders

Long-term outcome of thyroid function after amiodarone-induced thyrotoxicosis, as compared to subacute thyroiditis

Bogazzi, F., Dell’Unto, E., Tanda, M. L., Tomisti, L., Cosci, C., Aghini-Lombardi, F., Sardella, C., Pinchera, A. +2 more·2006·Journal of Endocrinological Investigation
DOI 10.1007/bf03344178
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Abstract

Background Two main forms of amiodarone- induced thyrotoxicosis (AIT) exist: type 1 AIT is a condition of true hyperthyroidism developing in patients with pre-existing thyroid disorders, and usually requires thyroid ablative treatment. On the other hand, type 2 AIT is a form of destructive thyroiditis occurring in normal thyroids, the management of which usually consists in glucocorticoid treatment.Aim To assess the long-term outcome of thyroid function in a prospective study of type 2 AIT patients, as compared to patients with De Quervain's subacute thyroiditis (SAT).Patients and methods Sixty consecutive patients with type 2 AIT were evaluated during oral glucocorticoid treatment (oral prednisone 30 mg/day, gradually tapered and withdrawn over a 3-month period) and followed for 38+/-4 months (range 6-72) thereafter. Sixty consecutive patients with SAT, referred to our Institutes during the same period and treated with the same therapeutic schedule, served as controls.Results Type 2 AIT patients were older (p<0.0001) and showed a larger male preponderance (M:F 3.6:1 vs 0.5:1, p<0.0001) than SAT patients. Mean serum free T4 (FT4) and free T3 (FT3) concentrations at diagnosis were increased in both conditions, but higher in type 2 AIT than in SAT (FT4 47.6+/-18.8 and 29.6+/-8.3 pmol/l, respectively, p<0.0001; FT3 15.4+/-7.0 and 11.2+/-3.0 pmol/l, respectively, p<0.001). Correction of thyrotoxicosis was obtained in all patients in both groups, but restoration of euthyroidism occurred earlier in SAT than in type 2 AIT (p=0.006). Ten type 2 AIT patients (17%) and 3 SAT patients (5%, p<0.03) became permanently hypothyroid after glucocorticoid withdrawal and required levothyroxine replacement.Conclusions A relevant proportion of type 2 AIT patients develop permanent hypothyroidism after correction of thyrotoxicosis. Thus, periodic surveillance of thyroid status is required after type 2 AIT.

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Authors
Bogazzi, F., Dell’Unto, E., Tanda, M. L., Tomisti, L., Cosci, C., Aghini-Lombardi, F., Sardella, C., Pinchera, A., Bartalena, L., & Martino, E.
Affiliations
  • University of Pisa (IT)
  • University of Insubria (IT)
Corresponding author
Bogazzi, F.
ORCID
Venue
Journal of Endocrinological Investigation
Publisher
Springer Science and Business Media LLC
Published
2006-09
Volume
29
Issue
8
Pages
694-699
ISSN
  • 0391-4097 (ISSN-L)
  • 1720-8386
DOI
10.1007/bf03344178
OpenAlex
W2083836553
Cited by
49
References
32
Citations by year
2026: 1 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 1 · 2012: 5
FWCI
3.85
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of Endocrinological Investigation (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • IrInSubria (University of Insubria) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
amiodarone-induced thyrotoxicosis, subacute thyroiditis, De Quervain's thyroiditis, glucocorticoid therapy, prednisone, permanent hypothyroidism, levothyroxine replacement, thyroid function, long-term outcomes, thyroid surveillance, hyperthyroidism
MeSH terms
Adult, Aged, Aged, 80 and over, Amiodarone, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Thyroid Function Tests, Thyroid Gland, Thyroiditis, Subacute, Thyrotoxicosis, Time Factors, Treatment Outcome

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