Successful Treatment of Amiodarone-Induced Thyrotoxicosis
Abstract
Background — Amiodarone-induced thyrotoxicosis (AIT) is a difficult management problem about which there are little published data. We examined whether continuing amiodarone or differentiating AIT into 2 subtypes affected outcome. Methods and Results — The type and duration of antithyroid treatment and response were recorded in a consecutive series of 28 cases. Comparisons were made between those in whom amiodarone either was continued or stopped and between those with either possible type 1 or type 2 AIT. Of the 28 cases, 5 had spontaneous resolution of AIT; 23 received carbimazole (CBZ) alone as first-line therapy. Eleven achieved long-term euthyroidism off CBZ or on a maintenance dose. Five became hypothyroid and required long-term thyroxine. Five relapsed after stopping CBZ treatment and were rendered euthyroid with either long-term CBZ (n=3) or radioiodine (n=2). Four were intolerant of CBZ and received propylthiouracil (PTU), with good effect in 3. One was resistant to thionamide alone (CBZ then PTU) and responded to adjunctive steroids. No difference in presentation or outcome was noted between those in whom amiodarone was continued or stopped or between possible type 1 or type 2 AIT. Conclusions — Continuing amiodarone has no adverse influence on response to treatment of AIT. First-line therapy with a thionamide alone is appropriate in iodine-replete areas, thus avoiding potential complications of other drugs. Differentiating between 2 possible types of AIT does not influence management or outcome.
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Some patients with mild type 2 AIT (approximately 20%) resolve spontaneously without stopping amiodarone or administering corticosteroids.
“As noted above, some patients with mild type 2 AIT (approximately 20%) resolve spontaneously without stopping amiodarone or administering corticosteroids (606,607).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [606]
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- Authors
- Osman, F., Franklyn, J. A., Sheppard, M. C., & Gammage, M. D.
- Affiliations
- University of Birmingham (GB)
- ORCID
- Osman, Faizel
- Venue
- Circulation
- Published
- 2002-03-19
- Volume
- 105
- Issue
- 11
- Pages
- 1275-1277
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2000171101
- Cited by
- 96
- References
- 12
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2021: 4 · 2020: 1 · 2019: 3 · 2018: 2 · 2016: 2 · 2015: 3 · 2014: 2 · 2013: 9 · 2012: 7
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- British Heart Foundation
- 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, antithyroid drug therapy, carbimazole, propylthiouracil, radioactive iodine, hypothyroidism, drug-induced thyroid dysfunction
- MeSH terms
- Aged, Amiodarone, Arrhythmias, Cardiac, Autoantibodies, Carbimazole, Female, Humans, Iodine Radioisotopes, Male, Middle Aged, Propylthiouracil, Retrospective Studies, Steroids, Thyrotoxicosis, Thyrotropin, Thyroxine, Triiodothyronine, Cohort Studies, Treatment Outcome
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