Total thyroidectomy can be utilized for symptomatic control in patients with severe, medically refractory amiodarone-induced thyrotoxicosis.
May support thyroidectomy in refractory amiodarone-induced thyrotoxicosis; leaves open need for prospective data before practice change.
Amiodarone is a class III antiarrhythmic drug widely used for both ventricular and supraventricular tachyarrhythmias. Due to its high iodine content and structural similarity to thyroxine, abnormalities in thyroid function are common in patients taking amiodarone, especially with long-term use. Both hypo- and hyperthyroidism have been associated with amiodarone, with the former far more common in the United States. We present a patient with medically refractory amiodarone-induced thyrotoxicosis after a 2-year history of amiodarone use, resulting in cardiac arrest and encephalopathy. The patient ultimately required total thyroidectomy for symptomatic control.
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Mehta et al. (2008) studied this question.
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