Total thyroidectomy for medically refractory amiodarone-induced thyrotoxicosis.

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Amiodarone is a Class III antiarrhythmic medication used for various tachyarrhythmias.
• Its iodine content and thyroxine-like structure frequently cause thyroid dysfunction with long-term use.
• Amiodarone-induced thyroid disease can manifest as hypothyroidism or hyperthyroidism.

Purpose of the Study:

• To report a case of medically refractory amiodarone-induced thyrotoxicosis.
• To emphasize the severe potential complications of amiodarone therapy on thyroid function.
• To illustrate the management of a critical case requiring surgical intervention.

Main Methods:

• Case report of a patient with a history of amiodarone use.
• Clinical presentation of amiodarone-induced thyrotoxicosis.
• Management of refractory hyperthyroidism and its complications.

Main Results:

• The patient developed medically refractory amiodarone-induced thyrotoxicosis after two years of amiodarone use.
• The condition led to severe complications, including cardiac arrest and encephalopathy.
• Total thyroidectomy was ultimately required for symptomatic management.

Conclusions:

• Amiodarone-induced thyrotoxicosis can be severe and refractory to medical treatment.
• Prompt recognition and aggressive management, including surgery, may be necessary for life-threatening complications.
• Clinicians should maintain a high index of suspicion for thyroid dysfunction in patients on long-term amiodarone therapy.