Amiodarone and thyroid

作者：Eskes Silvia A; Wiersinga Wilmar M^*

来源：Best Practice & Research Clinical Endocrinology & Metabolism, 2009, 23(6): 735-751.

DOI：10.1016/j.beem.2009.07.001

• amiodarone
• dronedarone
• thyroid function tests
• amiodarone-induced hypothyroidism
• amiodarone-induced thyrotoxicosis
• diagnosis
• treatment

Assessment of TSH and TPO-Ab before starting amiodarone (AM) treatment is recommended The usefulness of periodic TSH measurement every 6 months during AM treatment is limited by the often sudden explosive onset of AIT, and the spontaneous return Of a Suppressed TSH to not mal values in half of the cases AM-induced hypothyroidism develops rather early after starting treatment. preferentially in iodine-sufficient areas and in females with TPO-Ab: it is due to failure to escape from the Wolff-Charkoff effect, resulting in preserved radioiodine uptake. AM-Induced thyrotoxicosis (AIT) occurs at any time during treatment. preferentially in iodine-deficient regions and in males AIT can be classified in type t (iodide-induced thyrotoxicosis, best treated by potassium perchlorate in combination with thionamides and discontinuation of AM) and type 2 (destructive thyrotoxicosis, best treated by prednisone, discontinuation of AM may not be necessary). AFT is associated with a higher rate of major adverse cardiovascular events (especially of ventricular arrhythmias) Uncertainty Continues to exist with respect to the feasibility of continuation of AM despite AIT. the appropriate methods to distinguish between AIT

• 出版日期2009-12