The onset time of amiodarone-induced thyrotoxicosis (AIT) depends on AIT type
Open accessAbstract
Objective: Considering the different pathogenic mechanisms of the two main forms of amiodarone-induced thyrotoxicosis (AIT), we ascertained whether this results in a different onset time as well. Design and methods: We retrospectively analyzed the clinical records of 200 consecutive AIT patients (157 men and 43 women; mean age 62.2±12.6 years) referred to our Department from 1987 to 2012. The onset time of AIT was defined as the time elapsed from the beginning of amiodarone therapy and the first diagnosis of thyrotoxicosis, expressed in months. Factors associated with the onset time of AIT were evaluated by univariate and multivariate analyses. Results: The median onset time of thyrotoxicosis was 3.5 months (95% CI 2–6 months) in patients with type 1 AIT (AIT1) and 30 months (95% CI 27–32 months,P<0.001) in those with type 2 AIT (AIT2). Of the total number of patients, 5% with AIT1 and 23% with AIT2 (P=0.007) developed thyrotoxicosis after amiodarone withdrawal. Factors affecting the onset time of thyrotoxicosis were the type of AIT and thyroid volume (TV). Conclusions: The different pathogenic mechanisms of the two forms of AIT account for different onset times of thyrotoxicosis in the two groups. Patients with preexisting thyroid abnormalities (candidate to develop AIT1) may require a stricter follow-up during amiodarone therapy than those usually recommended. In AIT1, the onset of thyrotoxicosis after amiodarone withdrawal is rare, while AIT2 patients may require periodic tests for thyroid function longer after withdrawing amiodarone.
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A recent retrospective report including 200 AIT patients found that the onset of thyrotoxicosis was significantly earlier in type 1 (median 3.5 months, range 1-61 months) than type 2 (median 30 months, range 1-95 months; p < 0.001).
“A recent retrospective report including 200 AIT patients found that the onset of thyrotoxicosis was significantly earlier in type 1 (median 3.5 months, range 1-61 months) than type 2 (median 30 months, range 1-95 months; p < 0.001) (605).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [605]
Nineteen percent of patients (38/200) developed AIT a mean of 5.5 months after amiodarone was stopped, 36 of whom had type 2 AIT.
“Nineteen percent of patients (38/200) developed AIT a mean of 5.5 months after the drug was stopped, 36 of whom had type 2 AIT.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [605]
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- Authors
- Tomisti, L., Rossi, G., Bartalena, L., Martino, E., & Bogazzi, F.
- Affiliations
- University of Pisa (IT)
- Corresponding author
- Bogazzi, Fausto
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-09
- Volume
- 171
- Issue
- 3
- Pages
- 363-368
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2131469216
- Cited by
- 60
- References
- 27
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 1 · 2021: 5 · 2020: 4 · 2019: 7 · 2018: 11 · 2017: 5 · 2016: 3 · 2015: 1 · 2014: 3
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Zenodo (CERN European Organization for Nuclear Research) (other-oa)
- 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, onset time, thyroid volume
- MeSH terms
- Adult, Aged, Aged, 80 and over, Amiodarone, Female, Humans, Male, Middle Aged, Retrospective Studies, Thyrotoxicosis, Time Factors, Ultrasonography
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