Issues in amiodarone-induced thyrotoxicosis: Update and review of the literature

Maqdasy, Salwan; Benichou, Thomas; Dallel, Sarah; Roche, B.; Desbiez, F.; Montanier, Nathanaëlle; Batisse-Lignier, Marie; Tauveron, Igor

doi:10.1016/j.ando.2018.05.001

Cited by 27 publications

(22 citation statements)

References 59 publications

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“…Predisposing factors for amiodarone-induced thyrotoxicosis include environmental factors such as dietary iodine (deficiency), as well as intrinsic factors such as pre-existing thyroid pathology. Depending on these factors, a great variability exists regarding the incidence of amiodarone-induced thyroid dysfunction ranges (5-22%) [51,52,62,63].…”

Section: Risk Of Thyrotoxicosis After Amiodarone Administrationmentioning

confidence: 99%

“…Dietary iodine intake affects an individual's risk of amiodarone-induced thyroid dysfunction: in iodine-deficient areas, amiodarone-induced thyrotoxicosis (AIT) appears to be more common than hypothyroidism [64], whereas in iodine-sufficient areas, amiodarone-induced hypothyroidism is more common than hyperthyroidism [19]. The incidence of reported AIT in different studies varies but remains within the range of 5-10% in most studies [51,52,63]. As was reported in a previous study from the UK, AIT appears more frequently in men than in women [65], but the time of onset of AIT is unpredictable.…”

Section: Risk Of Thyrotoxicosis After Amiodarone Administrationmentioning

confidence: 99%

“…Type 3 AIT is a mixed form, existing an overlapping condition between type 1 and type 2 AIT. These types differ in their pathogenesis, clinical or paraclinical signs, and management [63].…”

Section: Clinical Forms Of Amiodarone-induced Hyperthyroidismmentioning

confidence: 99%

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Prevention and Treatment of Iodine-Induced Thyrotoxicosis

Kolcsár¹,

Gáll²

2020

Goiter - Causes and Treatment

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Etiologies of thyrotoxicosis are diverse, one of them being caused by iodineinduced hyperthyroidism. The clinical signs of the disease are the classical signs of any form of hyperthyroidism, but the treatment of the different forms presents particular aspects. This chapter reviews the risk factors for thyrotoxicosis following an excess iodine load, pointing out the major sources of iodine: supplementation programs, dietary intake, nutritional supplements, iodine-containing contrast medium, and amiodarone. Prevention of iodine-induced thyrotoxicosis is critical in geriatric patients who often have thyroid nodular disease, underlying heart conditions, and therefore, hyperthyroidism may be more difficult to detect clinically. Treatment of iodine-induced thyrotoxicosis could be performed with thioamides or perchlorate prior to the administration of an iodine containing product (e.g., food, dietary supplements, and contrast media). On the other hand, amiodarone-induced thyrotoxicosis needs further attention and a close collaboration between cardiology and endocrinology to overcome complications, but individualization of the therapy should be undertaken. Based on the specific features of amiodarone-induced thyrotoxicosis thioamides, perchlorate, high-dose glucocorticoids, or radioiodine therapy may be considered for an optimal therapeutic intervention.

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Section: Risk Of Thyrotoxicosis After Amiodarone Administrationmentioning

confidence: 99%

Section: Risk Of Thyrotoxicosis After Amiodarone Administrationmentioning

confidence: 99%

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Prevention and Treatment of Iodine-Induced Thyrotoxicosis

Kolcsár¹,

Gáll²

2020

Goiter - Causes and Treatment

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“…Thus, one can suggest that its interruption or continuation might not influence AIT management. Presently, amiodarone interruption in AIT1 is recommended to improve the response to ATDs, but in patients with AIT2, this is not compulsory (Maqdasy et al 2018).…”

Section: Treatmentmentioning

confidence: 99%

Thyrotoxicosis with concomitant thyroid cancer

Cheng

Jin

et al. 2019

Endocrine-Related Cancer

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Thyrotoxicosis with concomitant thyroid cancer is rare and poorly recognized, which may result in delayed diagnosis, inappropriate treatment and even poor prognosis. To provide a comprehensive guidance for clinicians, the etiology, pathogenesis, diagnosis and treatment of this challenging setting were systematically reviewed. According to literatures available, the etiologies of thyrotoxicosis with concomitant thyroid cancer were categorized into Graves’ disease with concurrent differentiated thyroid cancer (DTC) or medullary thyroid cancer, Marine–Lenhart Syndrome with coexisting DTC, Plummer’s disease with concomitant DTC, amiodarone-induced thyrotoxicosis with concomitant DTC, central hyperthyroidism with coexisting DTC, hyperfunctioning metastases of DTC and others. The underlying causal mechanisms linking thyrotoxicosis and thyroid cancer were elucidated. Medical history, biochemical assessments, radioiodine uptake, anatomic and metabolic imaging and ultrasonography-guided fine-needle aspiration combined with pathological examinations were found to be critical for precise diagnosis. Surgery remains a mainstay in both tumor elimination and control of thyrotoxicosis, while anti-thyroid drugs, beta-blockers, 131I, glucocorticoids, plasmapheresis, somatostatin analogs, dopamine agonists, radiation therapy, chemotherapy and tyrosine kinase inhibitors should also be appropriately utilized as needed.

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“…В среднем этот показатель равен 14-20% [9]. Частота возникновения АмИТ варьирует от 0,6 до 21% [10]. Этот преобладающий вариант дисфункции ЩЖ развивается в регионах с достаточным обеспечением йода.…”

Section: эпидемиологияunclassified

Amiodarone-induced thyrotoxicosis type 2: predictors and treatment options

et al. 2019

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Amiodarone-induced type 2 thyrotoxicosis remains a significant problem of modern endocrinology and cardiology. The unique pharmacological character and multifaceted properties of amiodarone explain its high prescription frequency and the leading position among antiarrhythmic drugs. In its turn, cytotoxicity and supra-physiological iodine content in the drug increase the risk of drug-induced destructive thyroiditis. The development of thyrotoxicosis leads to recurrence of cardiac arrhythmias, increased left ventricular dysfunction and manifestations of chronic heart failure. Correct identification of the type of thyrotoxicosis determines the subsequent patient management strategy. Glucocorticoids have been recognized as the first-line treatment among the possible therapy options. Rapid correction of thyrotoxicosis is crucial, especially in elderly patients with severe heart disease. Of interest for practical medicine is the search for specific predictors (deep understanding of the pathogenetic mechanisms) and new possibilities of therapy for amiodarone-induced thyrotoxicosis type 2.

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Issues in amiodarone-induced thyrotoxicosis: Update and review of the literature

Cited by 27 publications

References 59 publications

Prevention and Treatment of Iodine-Induced Thyrotoxicosis

Prevention and Treatment of Iodine-Induced Thyrotoxicosis

Thyrotoxicosis with concomitant thyroid cancer

Amiodarone-induced thyrotoxicosis type 2: predictors and treatment options

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