Amiodarone-Induced Thyrotoxicosis Late After Amiodarone Withdrawal

作者：Yagishita Atsuhiko^*; Hachiya Hitoshi; Kawabata Mihoko; Nakamura Tomofumi; Sugiyama Koji; Tanaka Yasuaki; Sasano Tetsuo; Isobe Mitsuaki; Hirao Kenzo

来源：Circulation Journal, 2013, 77(12): 2898-2903.

DOI：10.1253/circj.CJ-13-0220

• Amiodarone
• Amiodarone-induced hypothyroidism
• Amiodarone-induced thyrotoxicosis

Background: Amiodarone-induced thyrotoxicosis (AIT) may develop long after amiodarone withdrawal. This study sought to determine the incidence and clinical characteristics of AIT after amiodarone withdrawal. %26lt;br%26gt;Methods and Results: The incidence and clinical characteristics of AIT were examined retrospectively in 71 patients (51 males, mean age 65 13 years) whose amiodarone therapy had been discontinued after at least 1 month of administration. Five (7%) patients developed AIT late after amiodarone withdrawal (11 3 months): 2 patients exhibited exacerbation of heart failure by atrial fibrillation, 2 developed dyspnea on exertion, and 1 patient was asymptomatic. The patients who developed AIT had a high incidence of amiodarone-induced hypothyroidism during amiodarone therapy (100 vs. 24%, P=0.002), had received amiodarone therapy for longer (76 +/- 86 months vs. 16 +/- 22 months, P%26lt;0.001), with a larger cumulative dose (271.1 +/- 268.5g vs. 63.4 +/- 86.5g, P%26lt;0.001) compared with those who did not. In all 5 patients, AIT resolved spontaneously within 5 months without the use of steroids. %26lt;br%26gt;Conclusions: Occurrence of amiodarone-induced hypothyroidism during amiodarone therapy and long duration of therapy may be cautionary markers of late AIT.

• 出版日期2013-12