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

Wong, Ronnie Meiyi; Cheung, Wa; Stockigt, Jan R.; Topliss, Duncan J.

doi:10.1046/j.1445-5994.2003.00463.x

Cited by 32 publications

(36 citation statements)

References 29 publications

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“…By definition, AIT 1 is associated with the presence of thyroid nodules or a diffuse goitre, although a goitre and nodules can also be present in AIT 2 . Thyroid volume was not different between the two AIT types in some studies and was higher in AIT 1 in others . Hypo‐echoic glands can be found in both AIT 1 and AIT 2 .…”

Section: Us Scanning In Aitmentioning

confidence: 95%

“…In its classic description, AIT 1 occurs in patients with pre‐existing nodular or diffuse goitre, and AIT 2 in normal thyroid glands. However, the presence of a goitre or nodules is not specific for AIT 1 . In patients on amiodarone, serum‐free thyroxine (FT 4 ) typically lies between the upper end and up to 150% above the reference range; hence, it is a less useful test compared to free triiodothyronine (FT3) for the diagnosis of thyrotoxicosis .…”

Section: Differentiation Of Ait 1 and Ait 2: Is It Possible On Clinicmentioning

confidence: 99%

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Thyrotoxicosis associated with the use of amiodarone: the utility of ultrasound in patient management

Theodoraki

Vanderpump

2016

Clinical Endocrinology

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Amiodarone is an anti-arrhythmic drug that commonly affects the thyroid, causing hypothyroidism or thyrotoxicosis. Amiodarone-induced thyrotoxicosis (AIT) is caused by excessive thyroid hormone biosynthesis in response to iodine load in autonomously functioning thyroid glands with pre-existing nodular goitre or underlying Graves' disease (type 1 or AIT 1), or by a destructive thyroiditis typically occurring in normal glands (type 2 or AIT 2). Indeterminate or mixed forms are also recognized. The distinction is clinically useful as AIT 1 is treated predominantly with thionamides, whereas AIT 2 is managed with glucocorticoids. We review the tools used to differentiate type 1 from type 2 thyrotoxicosis, with specific reference to the imaging modalities used.

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Section: Us Scanning In Aitmentioning

confidence: 95%

Section: Differentiation Of Ait 1 and Ait 2: Is It Possible On Clinicmentioning

confidence: 99%

Thyrotoxicosis associated with the use of amiodarone: the utility of ultrasound in patient management

Theodoraki

Vanderpump

2016

Clinical Endocrinology

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“…The antiarrhythmic drug amiodarone has a 37% iodine content, with high tissue penetration and a half‐life of months. The elemental iodine load of about 9 mg per day from a 200 mg tablet can precipitate hyperthyroidism if there is pre‐existing goitre (type I amiodarone‐induced hyperthyroidism), while the drug itself causes thyroiditis in 5%–10% of users, typically after about 2 years of therapy (type II amiodarone‐induced hyperthyroidism, the most common form in Australia 14 ). Although type I may respond to high‐dose thionamide therapy, and type II to glucocorticoid therapy, these conditions can be severe and treatment‐resistant, and thyroidectomy may be needed.…”

Section: Hyperthyroidismmentioning

confidence: 99%

5: Diagnosis and management of hyperthyroidism and hypothyroidism

Topliss

Eastman

2004

Medical Journal of Australia

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The most common cause of hyperthyroidism in Australia is Graves disease, caused by a defect in immunoregulation in genetically predisposed individuals, leading to production of thyroid‐stimulating antibodies. Each of the three modalities of therapy for Graves disease — thionamide drugs, subtotal or total thyroidectomy, and radioactive iodine ablation — can render the patient euthyroid, but all have potential adverse effects and may not eliminate recurrences. Hypothyroidism occurs in about 5% of the adult population; most present with “subclinical” hypothyroidism (mild thyroid failure), characterised by raised levels of serum thyroid stimulating hormone (TSH) but normal free thyroxine (T4). The most common cause of hypothyroidism in Australia is autoimmune chronic lymphocytic thyroiditis, characterised by raised circulating levels of thyroid peroxidase antibody. Symptoms and signs of hypothyroidism are often mild or subtle and, when there is clinical suspicion, thyroid function tests are needed; if serum TSH level is raised, free T4 and thyroid peroxidase antibody should be measured. Replacement therapy with thyroxine is the cornerstone of therapy (1.6 μg/kg lean body weight daily, taken on an empty stomach); combination therapy with thyroxine and liothyronine (T3) is promoted, but there is little evidence of its clinical benefit. Despite the development of highly sensitive laboratory tests, clinical assessment and judgement remain paramount

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“…In a recent article, Wong et al. reported the use of colour‐flow Doppler sonography of the thyroid gland to predict the response or non‐response to steroid therapy 1 …”

Section: Patient Demographics Clinical Data and Thyroid Function Tementioning

confidence: 99%

Plasmapheresis as a potential treatment option for amiodarone‐induced thyrotoxicosis

Diamond

Rajagopal

Ganda

et al. 2004

Internal Medicine Journal

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

Cited by 32 publications

References 29 publications

Thyrotoxicosis associated with the use of amiodarone: the utility of ultrasound in patient management

Thyrotoxicosis associated with the use of amiodarone: the utility of ultrasound in patient management

5: Diagnosis and management of hyperthyroidism and hypothyroidism

Plasmapheresis as a potential treatment option for amiodarone‐induced thyrotoxicosis

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