Total thyroidectomy for amiodarone-associated thyrotoxicosis: should surgery always be delayed for pre-operative medical preparation?
Abstract
Objective: Amiodarone can induce severe hyperthyroidism that justifies its withdrawal and the introduction of antithyroid drugs. Continuing amiodarone use, failure to control hyperthyroidism and poor clinical progress may require thyroidectomy. This study aimed to evaluate patients’ post-operative development and mid-term outcome after thyroidectomy for amiodarone-associated thyrotoxicosis. Study design: Prospective case series. Setting: Tertiary care centre. Subjects and methods: We prospectively collected cases of amiodarone-associated thyrotoxicosis requiring thyroidectomy due to failure of antithyroid treatment, despite amiodarone discontinuation. Post-thyroidectomy complications were compared immediately, 30 days and one year post-operatively, and also for scheduled versus emergency surgery cases. Results: Of 11 total cases, nine scheduled thyroidectomy cases had no morbidity after elective surgery. Two cases required emergency surgery for multiple organ failure and cardiac problems. Immediate post-operative complications (mostly haemodynamic) occurred in both cases (emergency vs routine surgery,p = 0.018). Conclusion: In such cases, pre-operative medical treatment is vital to limit peri- and post-operative complications, but surgery should not be delayed if the haemodynamic status deteriorates. Surgery, with careful anaesthesia, is the cornerstone of the treatment.
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Several surgical series involving patients with AIT have now been published, with generally favorable results.
“Several surgical series involving patients with AIT have now been published, with generally favorable results (612,(614)(615)(616).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [615]
Cites
Guidelines for perioperative cardiovascular evaluation for noncardiac surgery
Eagle, K. A., Brundage, B. H., CHAITMAN, B. R., Ewy, G. A., Fleisher, L. A., HERTZER, N. R., Leppo, J. A., Ryan, T. J., Schlant, R. C., Spencer, W. H., et al. (1996) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(95)99999-x · Cited by 755 · see citing works
Myocardial Infarction after Noncardiac Surgery
Badner, N. H., Knill, R. L., Brown, J. E., Novick, T., & Gelb, A. W. (1998) · Anesthesiology · doi:10.1097/00000542-199803000-00005 · Cited by 395 · see citing works
Basaria, S. S., & Cooper, D. S. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2004.11.028 · Cited by 341 · see citing works
Iodine Excess and Hyperthyroidism
Roti, E., & Uberti, E. C. D. (2001) · Thyroid · doi:10.1089/105072501300176453 · Cited by 287 · see citing works
Effects of Amiodarone on Thyroid Function
Harjai, K. J., & Licata, A. A. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-126-1-199701010-00009 · Cited by 276 · see citing works
Incidence, predictability, and pathogenesis of amiodarone-induced thyrotoxicosis and hypothyroidism
Trip, M. D., Wiersinga, W. M., & Plomp, T. A. (1991) · The American Journal of Medicine · doi:10.1016/0002-9343(91)90187-3 · Cited by 269 · see citing works
[Effects of amiodarone on thyroid function].
Caron, P. J. (1995) · PubMed · Cited by 237 · see citing works
Bartalena, L., Brogioni, S., Grasso, L., Bogazzi, F., Burelli, A., & Martino, E. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.8.8768854 · Cited by 234 · see citing works
The Various Effects of Amiodarone on Thyroid Function
Bogazzi, F., Bartalena, L., Gasperi, M., Braverman, L. E., & Martino, E. (2001) · Thyroid · doi:10.1089/105072501300176471 · Cited by 152 · see citing works
Farling, P. A. (2000) · British Journal of Anaesthesia · doi:10.1093/bja/85.1.15 · Cited by 139 · see citing works
Iodine‐induced thyrotoxicosis: analysis of eighty‐five consecutive cases
Léger, A., MASSIN, J. P., Laurent, M. F., Vincens, M., Auriol, M., Helal, O. B., Chomette, G., & Savoie, J. C. (1984) · European Journal of Clinical Investigation · doi:10.1111/j.1365-2362.1984.tb01212.x · Cited by 109 · see citing works
Surgical Management of Amiodarone‐associated Thyrotoxicosis: Mayo Clinic Experience
Houghton, S. G., Farley, D. R., Brennan, M. D., van Heerden, J. A., Thompson, G. B., & Grant, C. S. (2004) · World Journal of Surgery · doi:10.1007/s00268-004-7599-6 · Cited by 103 · see citing works
Population pharmacokinetics of long-term oral amiodarone therapy
Pollak, P. T. (2000) · Clinical Pharmacology & Therapeutics · doi:10.1067/mcp.2000.107047 · Cited by 102 · see citing works
Amiodarone and thyroid function
Nademanee, K., Piwonka, R. W., Singh, B. N., et al. (1989) · Progress in Cardiovascular Diseases · doi:10.1016/0033-0620(89)90017-0 · Cited by 96 · see citing works
Kennedy, R. L., Griffiths, H., & Gray, T. A. (1989) · Clinical Chemistry · doi:10.1093/clinchem/35.9.1882 · Cited by 79 · see citing works
Amiodarone-associated thyrotoxicosis (AAT): experience with surgical management.
Brennan, van Heerden, J. A., & Carney, J. A. (1987) · PubMed · Cited by 68 · see citing works
Surgical Management of Amiodarone‐associated Thyrotoxicosis: Too Risky or Too Effective?
Hamoir, E., Meurisse, M., Deféchereux, T., Joris, J. L., Vivario, J., & Hennen, G. P. (1998) · World Journal of Surgery · doi:10.1007/pl00024613 · Cited by 54 · see citing works
Surgical Management of Amiodarone‐Induced Thyrotoxicosis
Franzese, C. B., Fan, C. Y., & Stack, B. C. (2003) · Otolaryngology · doi:10.1016/s0194-5998(03)01590-0 · Cited by 31 · see citing works
Amiodarone-induced thyrotoxicosis. A review.
Piga, M., Serra, A., Boi, F., et al. (2008) · PubMed · Cited by 27 · see citing works
Anaesthesia for Amiodarone-Induced Thyrotoxicosis: A Case Review
Sutherland, J., Robinson, B., & Delbridge, L. (2001) · Anaesthesia and Intensive Care · doi:10.1177/0310057x0102900104 · Cited by 27 · see citing works
Surgical management of amiodarone‐associated thyrotoxicosis
Gough, I. R., & Gough, J. (2002) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2002.tb04320.x · Cited by 23 · see citing works
SURGERY AND ANAESTHESIA FOR AMIODARONE‐ASSOCIATED THYROTOXICOSIS
Gough, I. R., & Meyer‐Witting, M. (2000) · Australian and New Zealand Journal of Surgery · doi:10.1046/j.1440-1622.2000.01816.x · Cited by 14 · see citing works
Thoracic inlet compression due to amiodarone induced goitre
Samanta, A., Jones, G. R., Burden, A. C., et al. (1985) · Postgraduate Medical Journal · doi:10.1136/pgmj.61.713.249 · Cited by 4 · see citing works
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Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
Bartalena, L., Bogazzi, F., Chiovato, L., Hubalewska-Dydejczyk, A., Links, T. P., & Vanderpump, M. (2018) · European Thyroid Journal · doi:10.1159/000486957 · Cited by 264 · see citing works
- Authors
- Pierret, C., Tourtier, J.-P., Pons, Y., Merat, S., Duverger, V, & Perrier, E.
- Affiliations
- HIA du Val-de-Grâce à Paris (FR)
- Brigade des Sapeurs Pompiers de Paris (FR)
- Hôpital d'instruction des Armées Percy (FR)
- Hôpital d'Instruction des Armées Bégin (FR)
- Corresponding author
- Pierret, C
- ORCID
- Merat, S
- Venue
- The Journal of Laryngology & Otology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-05-22
- Volume
- 126
- Issue
- 7
- Pages
- 701-705
- ISSN
- 0022-2151 (ISSN-L)
- 1748-5460
- OpenAlex
- W2068481430
- Cited by
- 31
- References
- 23
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 2 · 2018: 7 · 2017: 5 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 1
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Laryngology & Otology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- amiodarone, thyrotoxicosis, hyperthyroidism, total thyroidectomy, antithyroid drugs, postoperative complications, hemodynamic complications, anesthesia
- MeSH terms
- Adult, Aged, Aged, 80 and over, Amiodarone, Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Drug Therapy, Combination, Female, Glucocorticoids, Humans, Male, Methylprednisolone, Middle Aged, Perchlorates, Postoperative Complications, Preoperative Care, Prospective Studies, Severity of Illness Index, Antithyroid Agents, Thyroid Hormones, Thyroidectomy, Thyrotoxicosis, Time Factors, Treatment Outcome, Potassium Compounds
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