What is the clinical evidence from this study?

Study design: Case Report. Population: Amiodarone-induced thyrotoxicosis (n=1). Intervention: Amiodarone.

What does this research mean for the field?

Severe amiodarone-induced thyrotoxicosis can be refractory to combined medical management and require consideration of definitive thyroidectomy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a case of refractory amiodarone-induced thyrotoxicosis complicated by metabolic derangements that necessitated referral for definitive surgical management.

August 19, 2026CureusOpen Access

Refractory Amiodarone-Induced Thyrotoxicosis Requiring the Consideration of Thyroidectomy: A Case Report and Review of Management Challenges

Q: What are the key findings of this study?

A 61-year-old man developed severe, medically refractory amiodarone-induced thyrotoxicosis after 3.5 years of amiodarone therapy, ultimately requiring referral for definitive surgical management.

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Key result

Severe amiodarone-induced thyrotoxicosis proves medically refractory, requiring definitive thyroidectomy after 3.5 years of therapy.

Why the study?

Amiodarone-induced thyrotoxicosis is an uncommon but clinically significant complication associated with substantial morbidity, especially in patients with underlying cardiovascular disease.

Key Points

To report a case of refractory amiodarone-induced thyrotoxicosis complicated by metabolic derangements that necessitated referral for definitive surgical management.
Clinical evaluation and longitudinal monitoring of a 61-year-old male receiving amiodarone therapy for approximately 3.5 years for atrial fibrillation, ischaemic heart disease, and heart failure.
Diagnostic workup comprising serial thyroid function tests, thyroid autoantibody profiling, thyroid ultrasound with Doppler, and therapeutic trials of carbimazole and prednisolone.
The patient developed severe thyrotoxicosis with a free thyroxine level exceeding 100 pmol/L and TSH <0.01 mU/L, displaying negative autoantibodies (TRAb 1.5 IU/L, TPOAb 8 IU/mL) and normal-to-low thyroid vascularity.
Medical therapy with carbimazole and prednisolone led to an initial biochemical plateau with free thyroxine remaining elevated at 52 pmol/L at the end of month 8, prompting referral for thyroidectomy.
The clinical course was further complicated by euglycaemic diabetic ketoacidosis (pH 7.27, ketones 2.3 mmol/L) secondary to concurrent SGLT2 inhibitor use and thyrotoxicosis, followed by steroid-induced diabetes (HbA1c 73 mmol/mol).

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 61-year-old man with atrial fibrillation, ischemic heart disease, and heart failure who developed refractory amiodarone-induced thyrotoxicosis after 3.5 years of amiodarone therapy.

Exposure

Medical management of amiodarone-induced thyrotoxicosis (carbimazole up to 60 mg once daily, prednisolone 30 mg once daily, and discontinuation of amiodarone) followed by referral for thyroidectomy.

Outcome

Biochemical and clinical response to medical therapy for amiodarone-induced thyrotoxicosis.

Amiodarone-induced thyrotoxicosis can be refractory to medical therapy and complicated by metabolic derangements such as euglycaemic diabetic ketoacidosis, requiring multidisciplinary management and potential thyroidectomy.

Limitations

Single case report limits generalizability
No post-operative outcomes available as the patient remains on the surgical waiting list
No post-operative outcomes available as the patient remains on the waiting list

Discussion

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Implication

Severe amiodarone-induced thyrotoxicosis may prove refractory with metabolic complications; this case report leaves open optimal surgical referral thresholds.

Cite This Study

Yunas et al. (2026) conducted a case report in Amiodarone-induced thyrotoxicosis (n=1). Amiodarone was evaluated. A 61-year-old man developed severe, medically refractory amiodarone-induced thyrotoxicosis after 3.5 years of amiodarone therapy, ultimately requiring referral for definitive surgical management.

synapsesocial.com/papers/6a85634f03308d306e2d6717 https://doi.org/10.7759/cureus.114586

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Implication

Severe amiodarone-induced thyrotoxicosis may prove refractory with metabolic complications; this case report leaves open optimal surgical referral thresholds.

Refractory Amiodarone-Induced Thyrotoxicosis Requiring the Consideration of Thyroidectomy: A Case Report and Review of Management Challenges

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Refractory Amiodarone-Induced Thyrotoxicosis Requiring the Consideration of Thyroidectomy: A Case Report and Review of Management Challenges

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider