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Cited by 32Thyroid Disorders and TreatmentsOphthalmology and Eye DisordersThyroid Cancer Diagnosis and Treatment

Heterogeneity of amiodarone‐induced thyrotoxicosis: evaluation of colour‐flow Doppler sonography in predicting therapeutic response

Wong, R., Cheung, W., Stockigt, J. R., Topliss, D. J.·2003·Internal Medicine Journal
DOI 10.1046/j.1445-5994.2003.00463.x
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Abstract

Abstract Background: Amiodarone‐induced thyrotoxicosis (AIT) presents a therapeutic challenge because of its resistance to standard antithyroid therapy. In iodine‐deplete environments, colour‐flow Doppler sonography (CFDS) has allowed distinction between two types of AIT: (i) Type I AIT, associated with increased vascularity (CFDS I−III) and response to thionamide antithyroid drug and (ii) type II AIT, with no/little thyroid vascularity (CFDS 0) and prednisolone responsiveness. Aim: To clarify if CFDS patterns correlated with treatment outcomes in a retrospective study of 24 patients with AIT in an iodine‐replete environment. Methods: Medical records of patients who presented to a teaching hospital between January 1998 to December 2000 were reviewed. Results of CFDS, ultrasound measurement of thyroid size and technetium scanning of the thyroid were correlated with treatment responses, especially prednisolone responsiveness. Results: Thirteen of 24 patients showed CFDS 0. Twelve of these 13 were evaluable for prednisolone responsiveness, of whom seven (58%) were prednisolone‐responsive. Of 11 patients with CFDS I−III, four (36%) responded to antithyroid medication alone and only one of seven (14%) was prednisolone‐responsive. Euthyroidism was achieved twice as rapidly in patients with CFDS 0 than those with CFDS I‐III. Because of medical treatment failure, seven patients, from both CFDS groups, required urgent near‐total thyroidectomy which was successful and uncomplicated in all cases. Conclusions: CFDS is useful in the management of AIT because CFDS 0 correlates better with prednisolone response (58%) than CFDS I−III (14%). However, unlike experience in iodine‐deficient regions, the results of the present study revealed that treatment responses to thionamide or prednisolone were heterogeneous within uniform CFDS patterns. Thus, prednisolone‐­responsiveness was not consistently predicted by CFDS 0, but the presence of flow appeared to correlate with non‐response to prednisolone. (Intern Med J 2003; 33: 420−426)

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Authors
Wong, R., Cheung, W., Stockigt, J. R., & Topliss, D. J.
Affiliations
The Alfred Hospital (AU)
Corresponding author
Topliss, D. J.
ORCID
Topliss, D. J.
Venue
Internal Medicine Journal
Publisher
Wiley
Published
2003-09
Volume
33
Issue
9-10
Pages
420-426
ISSN
  • 1444-0903 (ISSN-L)
  • 1445-5994
DOI
10.1046/j.1445-5994.2003.00463.x
OpenAlex
W2077070523
Cited by
32
References
26
Citations by year
2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 1
FWCI
1.52
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 25 d)
Locations
  • Internal Medicine Journal (publishedVersion)
  • PubMed (publishedVersion)
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 › Thyroid Cancer Diagnosis and Treatment
Keywords
amiodarone-induced thyrotoxicosis, thyroid vascularity, treatment response prediction, near-total thyroidectomy
MeSH terms
Adult, Aged, Amiodarone, Anti-Arrhythmia Agents, Female, Glucocorticoids, Humans, Male, Middle Aged, Prednisolone, Thyroidectomy, Thyrotoxicosis, Ultrasonography, Doppler, Color

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