Amiodarone-Induced Thyrotoxicosis in Adults with Congenital Heart Disease -Clinical Presentation and Response to Therapy
Abstract
Objective The development of amiodarone-induced thyrotoxicosis (AIT) can threaten the hemodynamic stability of adult patients with congenital heart disease (CHD). Here, we describe the natural history and treatment response of AIT in this at-risk population.Methods We studied retrospectively all cases of AIT that occurred in CHD patients at our institution after a minimum of 3 months on amiodarone. Subjects were identified from the cohort of adults with CHD who were treated at the Mayo Clinic Adult CHD clinic between 1987 and 2009.Results We identified 23 cases of AIT: 7 were type 1, 13 were type 2, and 3 were undefined due to insufficient data. Most patients were symptomatic (17 of 23, 74%), with arrhythmia and weight loss as the most common symptoms. The majority (12 of 23, 52%) were initially observed; 10 patients (43%) were treated medically and 1 patient (5%) underwent thyroidectomy. Four patients from the observation group eventually required active treatment and 3 patients from the medical group required surgery. Asymptomatic patients tended to resolve under observation (5 of 7, 71.4%) rather than progress to active treatment (0 of 4) (P = .06). Discontinuation of amiodarone, AIT type, or use of perchlorate did not impact AIT duration.Conclusion AIT in CHD patients exhibits a wide range of severity and sensitivity to medical therapy. Asymptomatic patients display a trend toward AIT resolution with observation alone. Amiodarone continuation does not appear to impact management outcome or disease duration. Additional studies in this high-risk population could identify elements of pathophysiology that would point toward better disease prevention and treatment.
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Type 2 AIT typically responds to treatment even if amiodarone therapy is continued, but continuation may lead to a more prolonged time to recovery and a higher rate of future recurrences of AIT.
“In addition, type 2 AIT typically responds to treatment even if amiodarone therapy is continued (585-587), but continuation may lead to a more prolonged time to recovery and a higher rate of future recurrences of AIT (588).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [587]
Cites
Sackett, D. L. (1979) · Journal of Chronic Diseases · doi:10.1016/0021-9681(79)90012-2 · Cited by 2,075 · see citing works
Congenital Heart Disease in the General Population
Marelli, A. J., Mackie, A. S., Ionescu‐Ittu, R., Rahme, E., & Pilote, L. (2007) · Circulation · doi:10.1161/circulationaha.106.627224 · Cited by 1,747 · see citing works
Task Force 1: the changing profile of congenital heart disease in adult life
Warnes, C. A., Liberthson, R. R., Danielson, G. K., Dore, A., Harris, L., Hoffman, J. I. E., Somerville, J., Williams, R. G., & Webb, G. D. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01272-4 · Cited by 1,443 · see citing works
Self-citationAtrial Arrhythmias in Adults With Congenital Heart Disease
Bouchardy, J., Therrien, J., Pilote, L., Ionescu-Ittu, R., Martucci, G., Bottega, N., & Marelli, A. J. (2009) · Circulation · doi:10.1161/circulationaha.109.866319 · Cited by 476 · see citing works
Environmental Iodine Intake and Thyroid Dysfunction During Chronic Amiodarone Therapy
Martino, E., SAFRAN, M., AGHINI-LOMBARDI, F., RAJATANAVIN, R., LENZIARDI, M., FAY, M., PACCHIAROTTI, A., ARONIN, N., MACCHIA, E., HAFFAJEE, C., et al. (1984) · Annals of Internal Medicine · doi:10.7326/0003-4819-101-1-28 · Cited by 370 · 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
Approach to the Patient with Amiodarone-Induced Thyrotoxicosis
Bogazzi, F., Bartalena, L., & Martino, E. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0180 · Cited by 207 · see citing works
Serum interleukin-6 in amiodarone-induced thyrotoxicosis
Bartalena, L., Grasso, L., Brogioni, S., Aghini-Lombardi, F., Braverman, L. E., & Martino, E. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.78.2.8106631 · Cited by 172 · see citing works
Effects of amiodarone therapy on thyroid function
Cohen-Lehman, J., Dahl, P., Danzi, S., & Klein, I. (2010) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.225 · Cited by 157 · see citing works
Amiodarone-Associated Thyroid Dysfunction
Thorne, S., Barnes, I. M., Cullinan, P., & Somerville, J. (1999) · Circulation · doi:10.1161/01.cir.100.2.149 · Cited by 149 · see citing works
Eskes, S. A., & Wiersinga, W. M. (2009) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2009.07.001 · Cited by 148 · see citing works
Eaton, S. E. M., Euinton, H. A., Newman, C. M., Weetman, A. P., & Bennet, W. M. (2002) · Clinical Endocrinology · doi:10.1046/j.0300-0664.2001.01457.x · Cited by 139 · 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
Self-citationSuccessful Treatment of Amiodarone-Induced Thyrotoxicosis
Osman, F., Franklyn, J. A., Sheppard, M. C., & Gammage, M. D. (2002) · Circulation · doi:10.1161/circ.105.11.1275 · Cited by 96 · see citing works
Piga, M., Cocco, M. C., Serra, A., Boi, F., Loy, M., & Mariotti, S. (2008) · European Journal of Endocrinology · doi:10.1530/eje-08-0348 · Cited by 90 · see citing works
Amiodarone-Induced Thyrotoxicosis
Conen, D., Melly, L., Kaufmann, C. C., Bilz, S., Ammann, P., Schaer, B. A., Sticherling, C., Müller-Stich, B. P., & Osswald, S. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.02.054 · Cited by 87 · see citing works
Tanda, M. L., Piantanida, E., Lai, A., Liparulo, L., Sassi, L., Bogazzi, F., Wiersinga, W. M., Braverman, L. E., Martino, E., & Bartalena, L. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03268.x · Cited by 81 · see citing works
Treatment of Amiodarone-Induced Thyrotoxicosis Type 2: A Randomized Clinical Trial
Eskes, S. A., Endert, E., Fliers, E., Geskus, R. B., Dullaart, R. P. F., Links, T. P., & Wiersinga, W. M. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2390 · Cited by 78 · see citing works
Bogazzi, F., Bartalena, L., Dell'Unto, E., Tomisti, L., Rossi, G., Pepe, P., Tanda, M. L., Grasso, L., Macchia, E., Aghini-Lombardi, F., et al. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.02920.x · Cited by 74 · see citing works
Ahmed, S., Van Gelder, I. C., Wiesfeld, A. C. P., Van Veldhuisen, D. J., & Links, T. P. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04087.x · Cited by 72 · see citing works
Bogazzi, F., Bartalena, L., Tomisti, L., Rossi, G., Brogioni, S., & Martino, E. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1678 · Cited by 59 · see citing works
Bogazzi, F., Dell’Unto, E., Tanda, M. L., Tomisti, L., Cosci, C., Aghini-Lombardi, F., Sardella, C., Pinchera, A., Bartalena, L., & Martino, E. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03344178 · Cited by 49 · see citing works
A Stepwise Approach to the Treatment of Amiodarone-Induced Thyrotoxicosis
Erdoğan, M. F., Güleç, S., Tutar, E., Başkal, N., & Erdoğan, G. (2003) · Thyroid · doi:10.1089/105072503321319521 · Cited by 42 · see citing works
Stan, M., Ammash, N., Warnes, C., Brennan, M. D., Thapa, P., Nannenga, M. R., & Bahn, R. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.02.015 · Cited by 38 · see citing works
Self-citationContinuation of Amiodarone Therapy Despite Type II Amiodarone-Induced Thyrotoxicosis
Uzan, L., Guignat, L., Meune, C., Mouly, S., Weber, S., Bertagna, X., Bertherat, J., Thomopoulos, P., & Duboc, D. (2006) · Drug Safety · doi:10.2165/00002018-200629030-00006 · Cited by 31 · see citing works
Treatment of amiodarone-associated thyrotoxicosis
Franklyn, J. A., & GAMMAGE, M. D. (2007) · Nature Clinical Practice Endocrinology & Metabolism · doi:10.1038/ncpendmet0592 · Cited by 30 · see citing works
Shiga, T., Wakaumi, M., Matsuda, N., Shoda, M., Hagiwara, N., Sato, K., & Kasanuki, H. (2001) · Japanese Circulation Journal-english Edition · doi:10.1253/jcj.65.958 · Cited by 24 · see citing works
Sato, K., Shiga, T., Matsuda, N., Onoda, N., Takano, K., Hagiwara, N., & Kasanuki, H. (2006) · Endocrine Journal · doi:10.1507/endocrj.k06-027 · Cited by 23 · see citing works
Stan, M., Hess, E., Bahn, R., Warnes, C., Ammash, N., Brennan, M. D., Thapa, P., & Montori, V. (2012) · Journal of Thyroid Research · doi:10.1155/2012/210529 · Cited by 22 · 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
Self-citationAl‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.054 · Cited by 1,883 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000549 · Cited by 750 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.10.035 · Cited by 730 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.053 · Cited by 685 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.10.036 · Cited by 639 · see citing works
Al-Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T., Field, M. E., Fonarow, G. C., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000548 · Cited by 412 · see citing works
Thyroidectomy for Amiodarone-Induced Thyrotoxicosis: Mayo Clinic Experience
Kotwal, A., Clark, J. E., Lyden, M. L., McKenzie, T. J., Thompson, G. B., & Stan, M. N. (2018) · Journal of the Endocrine Society · doi:10.1210/js.2018-00259 · Cited by 41 · see citing works
Self-citationTakeuchi, D., Honda, K., Shinohara, T., Inai, K., Toyohara, K., & Nakanishi, T. (2015) · Circulation Journal · doi:10.1253/circj.cj-15-0042 · Cited by 31 · see citing works
Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023
Teixeira, R. A., Fagundes, A. A., Baggio, J. M., de Oliveira, J. C., Medeiros, P. D. T. J., Valdigem, B. P., Teno, L. A. C., Silva, R. T., de Melo, C. S., Elías, J., et al. (2023) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20220892 · Cited by 50 · see citing works
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Moore, B. M., Cordina, R., McGuire, M. A., & Celermajer, D. S. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.06.066 · Cited by 17 · see citing works
Clinical practice guidelines for acute and chronic thyroiditis (excluding autoimmune thyroiditis)
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Tireotoxicose Induzida pela Amiodarona - Revisão de Literatura e Atualização Clínica
de Souza, L. V. F., Campagnolo, M. T., Martins, L. C. B., & Scanavacca, M. (2021) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20190757 · Cited by 9 · see citing works
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Bračko, S., & Čelofiga, A. (2024) · Archives of Psychiatry Research · doi:10.20471/feb.2024.60.01.08 · Cited by 6 · see citing works
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Self-citationClark, J. E., & Stan, M. N. (2021) · Clinical Thyroidology · doi:10.1089/ct.2021;33.388-390
Self-citation(2016) · Reactions Weekly · doi:10.1007/s40278-016-21389-4
- Authors
- Stan, M. N., Sathananthan, M., Warnes, C. A., Brennan, M. D., Thapa, P., & Bahn, R. S.
- Affiliations
- Mayo Clinic (US)
- Central DuPage Hospital (US)
- Corresponding author
- Stan, Marius N.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 20
- Issue
- 1
- Pages
- 33-40
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2121668825
- Cited by
- 18
- References
- 30
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 4 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 1
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Center for Research Resources (UL1RR024150)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- amiodarone-induced thyrotoxicosis, congenital heart disease, adult congenital heart disease, medical therapy, perchlorate, thyroidectomy, natural history (disease), cardiac arrhythmias, weight loss, drug-induced thyroid dysfunction
- MeSH terms
- Adult, Amiodarone, Female, Heart Defects, Congenital, Humans, Male, Retrospective Studies, Thyrotoxicosis
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