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ABSTRACT
Amiodarone is an antiarhythmic drug which may produce secondary effects on the thyroid function. We report a case of severe amiodarone-induced thyrotoxicosis in a 56-year-old patient. Because of dramatic clinical manifestations, plasmapheresis was performed as a first step in management of thyrotoxicosis and an improvemen t of clinical status was observed. Pharmacological therapy with thionamide, dexamethasone, betablocker and lithium carbonate was started. Clinical status worsened progressively and the decision to operate was made after 9 weeks of inefficient pharmacological therapy. Before surgery, the patient was submitted to plasmapheresis daily and she became euthyroid after the 5th plasmapheresis. Subsequently, total thyroidectomy was performed which resulted in an absolute cure of thyrotoxicosis without complications. We suggest that a combination of plasmapheresis and thyroidectomy warrants consideration as definitive treatment for resistant amiodarone-induced thyro - toxicosis.
Amiodarone is an antiarhythmic drug which may produce secondary effects on the thyroid function. We report a case of severe amiodarone-induced thyrotoxicosis in a 56-year-old patient. Because of dramatic clinical manifestations, plasmapheresis was performed as a first step in management of thyrotoxicosis and an improvemen t of clinical status was observed. Pharmacological therapy with thionamide, dexamethasone, betablocker and lithium carbonate was started. Clinical status worsened progressively and the decision to operate was made after 9 weeks of inefficient pharmacological therapy. Before surgery, the patient was submitted to plasmapheresis daily and she became euthyroid after the 5th plasmapheresis. Subsequently, total thyroidectomy was performed which resulted in an absolute cure of thyrotoxicosis without complications. We suggest that a combination of plasmapheresis and thyroidectomy warrants consideration as definitive treatment for resistant amiodarone-induced thyro - toxicosis.