Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jan 1;57(1):59-63.
doi: 10.2169/internalmedicine.9177-17. Epub 2017 Oct 16.

Amiodarone-induced Thyrotoxicosis with Cardiopulmonary Arrest

Kosuke Inoue  1 , Jun Saito  1 , Tetsuo Kondo  2 , Kaoru Miki  3 , Chiho Sugisawa  1 , Yuya Tsurutani  1 , Naoki Hasegawa  4 , Shinya Kowase  5 , Yukio Kakuta  4 , Masao Omura  1 , Tetsuo Nishikawa  1
Affiliations
Case Reports

Amiodarone-induced Thyrotoxicosis with Cardiopulmonary Arrest

Kosuke Inoue et al. Intern Med. .

Abstract

We describe a case of amiodarone-induced thyrotoxicosis (AIT) with cardiopulmonary arrest (CPA) in a 49-year-old woman. The patient had been treated with amiodarone for non-sustained ventricular tachycardia. Two weeks prior to her admission, she developed thyrotoxicosis and prednisolone (PSL, 30 mg daily) was administered with the continuation of amiodarone. However, she was admitted to our hospital for CPA. We performed total thyroidectomy to control her thyrotoxicosis and the pathological findings were consistent with type 2 AIT. She gradually improved and was discharged on day 84. This case demonstrates the importance of considering immediate total thyroidectomy for patients with uncontrollable AIT.

Keywords: amiodarone-induced thyrotoxicosis; cardiopulmonary arrest; hyperthyroxinemia; prednisolone; thyroidectomy.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Thyroid ultrasound. Right lobe, 2.2 (wide) ×2.7 (depth) ×7.5 (length) cm; left lobe, 2.1×2.4×7.4 cm; Isthmus, 0.36×3.1 cm. The thyroid volume, as calculated by the ellipsoid formula, was 43.5 cm3. Color flow Doppler sonography revealed no intraparenchymal vascularity.
Figure 2.
Figure 2.
The pathological findings of the thyroid. Atrophic follicles with interstitial fibrosis [a and b: Hematoxylin and Eosin (H&E) staining]. Disrupted follicles with detachment of the follicular epithelium and the macrophage infiltration (c: H&E staining). Cytoplasmic vacuolization and lipofuscin in flattened follicular epithelial cells (d: H&E staining).
Figure 3.
Figure 3.
The clinical course. Two weeks after the administration of prednisolone (PSL) for amiodarone-induced thyrotoxicosis, she had an episode of cardiopulmonary arrest (CPA). Total thyroidectomy was performed on day 7 to treat her uncontrolled hyperthyroxinemia. After resection, her thyroid hormone levels gradually decreased. The PSL dose was tapered and levothyroxine was started. Amiodarone was continued to control her non-sustained ventricular tachycardia (NSVT). After rehabilitation, she finally discharged on day 84.
See this image and copyright information in PMC

References

    1. Basaria S, Cooper DS. Amiodarone and the thyroid. Am J Med 118: 706-714, 2005. - PubMed
    1. Martino E, Bartalena L, Bogazzi F, Braverman LE. The effects of amiodarone on the thyroid. Endocr Rev 22: 240-254, 2001. - PubMed
    1. Bogazzi F, Bartalena L, Martino E. Approach to the patient with amiodarone-induced thyrotoxicosis. J Clin Endocrinol Metab 95: 2529-2535, 2010. - PubMed
    1. Uchida T, Kasai T. Prevalence of amiodarone-induced thyrotoxicosis and associated risk factors in Japanese patients. 2014: 534904, 2014. - PMC - PubMed
    1. Mehta AN, Vallera RD, Tate CR, Sager RA, Welch BJ. Total thyroidectomy for medically refractory amiodarone-induced thyrotoxicosis. Bayl Univ Med Cent 21: 382-385, 2008. - PMC - PubMed

Publication types