Key result
Thyroidectomy resolves refractory amiodarone-induced thyrotoxicosis, improving heart failure symptoms and arrhythmia control.
Why the study?
Amiodarone-induced thyrotoxicosis is usually treated conservatively, but surgical treatment is necessary in cases refractory to medical therapy, especially with multiple organ failure.
Does thyroidectomy improve clinical outcomes in a patient with refractory amiodarone-induced thyrotoxicosis and multiple organ failure?
Case Report (n=1)
Does thyroidectomy improve clinical outcomes in a patient with refractory amiodarone-induced thyrotoxicosis and multiple organ failure?
Thyroidectomy can be a viable and effective life-saving intervention for patients with amiodarone-induced thyrotoxicosis refractory to medical therapy, even in the setting of multiple organ failure.
May support thyroidectomy in refractory amiodarone-induced thyrotoxicosis with organ failure; hypothesis-generating, needs prospective validation.
Amiodarone is a drug used in the treatment of life-threatening arrhythmias, which can lead to the development of amiodarone-induced thyrotoxicosis. In most cases this pathology can be treated by conservative methods; surgical treatment is resorted to in cases of thyrotoxicosis refractory to medical treatment. This case report describes surgical treatment of a patient with amiodarone-induced thyrotoxicosis, progressive heart failure, neurological pathology, bilateral pneumonia, functioning tracheostomy, systemic infectious process, multiple organ dysfunction syndrome, who was treated in the intensive care unit. Due to the lack of response to therapy with antithyroid drugs (thiamazole, lithium preparations and pulse therapy with prednisolone) and a progressive deterioration of the condition in a short period of time, according to vital indicators, the patient underwent thyroidectomy. In the postoperative period, there was a decrease in the occurrence of chronic heart failure symptoms. Medical control of cardiac arrhythmias was achieved. Surgical stage proceeded without complications in the period of 30-days. The patient was discharged for outpatient rehabilitation treatment.
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Салов et al. (2022) conducted a case report in Amiodarone-induced thyrotoxicosis with multiple organ failure (n=1). Thyroidectomy was evaluated on Clinical improvement (decrease in chronic heart failure symptoms, medical control of cardiac arrhythmias, surgical complications). Thyroidectomy successfully treated a patient with amiodarone-induced thyrotoxicosis refractory to medical therapy and multiple organ failure, leading to decreased heart failure symptoms and arrhythmia control.
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