A Case Report on Type 2 Amiodarone Induced Thyrotoxicosis and Hypercalcemia

Area of Science:

• Endocrinology
• Cardiology

Background:

• Amiodarone is a common antiarrhythmic drug with known thyroid-related side effects, including hypothyroidism and hyperthyroidism.
• Amiodarone-induced thyrotoxicosis (AIT) can manifest in different types, affecting thyroid hormone regulation.

Observation:

• A 64-year-old male patient with pre-existing conditions presented with symptoms suggestive of worsening heart failure and thyrotoxicosis.
• Laboratory results revealed suppressed TSH, elevated free triiodothyronine (FT3) and free thyroxine (FT4), and notably, hypercalcemia.

Findings:

• This case highlights a rare presentation of Type 2 AIT accompanied by hypercalcemia.
• The patient's hypercalcemia was managed with calcitonin and intravenous fluids.
• A combination therapy of propylthiouracil and prednisone was effective in normalizing thyroid hormone levels and resolving hypercalcemia.

Implications:

• This case underscores the importance of considering hypercalcemia in the differential diagnosis of AIT.
• Combined therapy with propylthiouracil and prednisone may be a viable treatment option for complex AIT cases.
• Further research into the mechanisms linking AIT and hypercalcemia could improve patient management.