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Thyroidectomy for amiodarone-induced thyrotoxicosis.

A P Farwell¹, S L Abend, S K Huang

¹Division of Endocrinology and Metabolism, University of Massachusetts Medical School, Worcester 01655.

|March 16, 1990

Summary

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Amiodarone-induced thyrotoxicosis is difficult to treat. Near-total thyroidectomy offers a rapid and effective solution for resistant cases, allowing continued amiodarone therapy.

Area of Science:

Endocrinology
Cardiology

Background:

Amiodarone hydrochloride, an iodine-rich antiarrhythmic, can induce thyrotoxicosis, particularly in iodine-deficient regions.
Treatment challenges arise from amiodarone's long half-life, patient comorbidities, and the necessity of continued amiodarone use.

Observation:

A patient with severe amiodarone-induced thyrotoxicosis refractory to medical management (methimazole, potassium perchlorate, iopanoic acid, dexamethasone) was reported.
The patient had received amiodarone for 34 months.

Findings:

Near-total thyroidectomy rapidly resolved the severe thyrotoxicosis.
Surgical intervention provided swift control of the hyperthyroid state.

Implications:

Near-total thyroidectomy is a viable definitive treatment for amiodarone-induced thyrotoxicosis resistant to medical therapy.

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Surgery enables continued amiodarone treatment, crucial for managing tachyarrhythmias.