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Amiodarone-associated thyrotoxicosis (AAT): experience with surgical management
M D Brennan1, J A van Heerden, J A Carney
1Department of Surgery and Pathology, Mayo Clinic, Rochester, MN 55905.
Surgery
|December 1, 1987
Summary
Amiodarone-induced thyrotoxicosis can be safely and effectively treated with near-total thyroidectomy in patients requiring continued amiodarone therapy for cardiac arrhythmias.
Area of Science:
- Cardiology
- Endocrinology
- Thyroidology
Background:
- Amiodarone, an iodine-rich antiarrhythmic drug, is associated with thyrotoxicosis.
- Thyrotoxicosis occurs in 1.5% of patients treated with amiodarone.
- Standard treatments like radioablation and antithyroid drugs are often ineffective or contraindicated.
Purpose of the Study:
- To evaluate the safety and efficacy of near-total thyroidectomy for amiodarone-associated thyrotoxicosis.
Main Methods:
- Retrospective review of 529 patients treated with amiodarone.
- Analysis of eight patients who developed thyrotoxicosis.
- Surgical management with near-total thyroidectomy in six patients.
Main Results:
- Near-total thyroidectomy led to rapid correction of hyperthyroidism in all treated patients.
- No intraoperative or postoperative arrhythmias occurred.
- Patients required thyroid hormone replacement post-surgery.
Conclusions:
- Near-total thyroidectomy is a safe and effective option for managing amiodarone-associated thyrotoxicosis.
- This surgical approach is suitable for patients who need to continue amiodarone treatment.
- Long-term thyroid hormone replacement is necessary after surgery.