RETROSPECTIVE EVALUATION OF DIAGNOSTIC METHODS AND TREATMENT OPTIONS IN AMIODARONE-INDUCED THYROTOXICOSIS

Nezahat Müge Çatıkkaş; Hülya Hacişahinoğulları; Nurdan Gül; Özlem Soyluk Selçukbiricik; Ferihan Aral; Refik Tanakol; Ayşe Kubat Üzüm

Article Details

RETROSPECTIVE EVALUATION OF DIAGNOSTIC METHODS AND TREATMENT OPTIONS IN AMIODARONE-INDUCED THYROTOXICOSIS

Authors:

Nezahat Müge Çatıkkaş | Hülya Hacişahinoğulları | Nurdan Gül | Özlem Soyluk Selçukbiricik | Ferihan Aral | Refik Tanakol | Ayşe Kubat Üzüm

Publisher:

Istanbul University

Main Topics:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Journal:

İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 3, pp.227-234

Document Type:

Article

Publication Date:

10/2023

Document Language:

English

Document ID (Org No.):

2001293735

pISSN:

1305-6441

Keywords:

Abstract:

 Objective: Amiodarone-induced thyrotoxicosis is an important cause of morbidity and mortality that is difficult for physicians to recognize and manage. We retrospectively analyzed the parameters used for diagnosis, classification, and treatment for amiodarone-induced thyrotoxicosis. Material and Method: We included patients who had amiodarone-induced thyrotoxicosis AIT. We recorded the demographics, the presence and characteristics of heart and thyroid diseases, the time and dosage of amiodarone exposure, thyroid function tests and thyroid auto-antibodies, and the diagnostic methods and management of thyroid disease. Result: We included 25 patients mean age: 64.115.3 years, 56 male who were classified as type 1 n:12; 48, type 2 n:7; 28, and mixed-type amiodarone-induced thyrotoxicosis AIT n:6; 24. In the comparison of type 1 AIT to 2 AIT, free T3 and T4 concentrations were 5.11.6 pmolL vs. 7.62.4 pmolL, and 29.28.8 pmolL vs. 34.911pmolL, respectively. Iodine uptake measurement at the 2nd hours were positively correlated with the 24th-hour measurement p0.005. Antithyroid drug n:20 was given for 24 months, glucocorticoid n:7 and sodium perchlorate n:5 were given for 7.41.7 and 3.52 months, respectively. The first treatment option was methimazole for type 1 AIT and methylprednisolone for type 2 AIT. The duration of remission was shorter in type 2 AIT p0.009. Five patients had radioactive iodine treatment, and one underwent thyroidectomy. Conclusion: The management of AITs is difficult. It should be kept in mind that these patients may need amiodarone again; therefore, ablative treatments should be planned if needed.

 Objective: Amiodarone-induced thyrotoxicosis is an important cause of morbidity and mortality that is difficult for physicians to recognize and manage. We retrospectively analyzed the parameters used for diagnosis, classification, and treatment for amiodarone-induced thyrotoxicosis. Material and Method: We included patients who had amiodarone-induced thyrotoxicosis AIT. We recorded the demographics, the presence and characteristics of heart and thyroid diseases, the time and dosage of amiodarone exposure, thyroid function tests and thyroid auto-antibodies, and the diagnostic methods and management of thyroid disease. Result: We included 25 patients mean age: 64.115.3 years, 56 male who were classified as type 1 n:12; 48, type 2 n:7; 28, and mixed-type amiodarone-induced thyrotoxicosis AIT n:6; 24. In the comparison of type 1 AIT to 2 AIT, free T3 and T4 concentrations were 5.11.6 pmolL vs. 7.62.4 pmolL, and 29.28.8 pmolL vs. 34.911pmolL, respectively. Iodine uptake measurement at the 2nd hours were positively correlated with the 24th-hour measurement p0.005. Antithyroid drug n:20 was given for 24 months, glucocorticoid n:7 and sodium perchlorate n:5 were given for 7.41.7 and 3.52 months, respectively. The first treatment option was methimazole for type 1 AIT and methylprednisolone for type 2 AIT. The duration of remission was shorter in type 2 AIT p0.009. Five patients had radioactive iodine treatment, and one underwent thyroidectomy. Conclusion: The management of AITs is difficult. It should be kept in mind that these patients may need amiodarone again; therefore, ablative treatments should be planned if needed.

 Objective: Amiodarone-induced thyrotoxicosis is an important cause of morbidity and mortality that is difficult for physicians to recognize and manage. We retrospectively analyzed the parameters used for diagnosis, classification, and treatment for amiodarone-induced thyrotoxicosis. Material and Method: We included patients who had amiodarone-induced thyrotoxicosis AIT. We recorded the demographics, the presence and characteristics of heart and thyroid diseases, the time and dosage of amiodarone exposure, thyroid function tests and thyroid auto-antibodies, and the diagnostic methods and management of thyroid disease. Result: We included 25 patients mean age: 64.115.3 years, 56 male who were classified as type 1 n:12; 48, type 2 n:7; 28, and mixed-type amiodarone-induced thyrotoxicosis AIT n:6; 24. In the comparison of type 1 AIT to 2 AIT, free T3 and T4 concentrations were 5.11.6 pmolL vs. 7.62.4 pmolL, and 29.28.8 pmolL vs. 34.911pmolL, respectively. Iodine uptake measurement at the 2nd hours were positively correlated with the 24th-hour measurement p0.005. Antithyroid drug n:20 was given for 24 months, glucocorticoid n:7 and sodium perchlorate n:5 were given for 7.41.7 and 3.52 months, respectively. The first treatment option was methimazole for type 1 AIT and methylprednisolone for type 2 AIT. The duration of remission was shorter in type 2 AIT p0.009. Five patients had radioactive iodine treatment, and one underwent thyroidectomy. Conclusion: The management of AITs is difficult. It should be kept in mind that these patients may need amiodarone again; therefore, ablative treatments should be planned if needed.

 Amaç: Amiodarona bağlı tirotoksikoz ABT hekimler için tanıması ve yönetimi zor, morbidite ve mortalitesi yüksek bir durumdur. Bu çalışmada ABT tanısı, sınıflandırılması ve tedavi için kullanılan parametrelerin retrospektif olarak incelenmesi amaçlanmıştır. Gereç ve Yöntem: Amiodarona bağlı tirotoksikoz nedeniyle ayaktan tedavi gören hastalar dahil edildi. Demografik özellikler, kalp ve tiroid hastalıklarının varlığı ve özellikleri, amiodaron maruziyetinin zamanı ve dozu, tiroid fonksiyon testleri ve otoantikorları ve tiroid hastalığının tanı yöntemleri ve yönetimi kaydedildi. Bulgular: Tip 1 n:12; 48, tip 2 n:7; 28 ve mikst tip n:6; 24 ABT olarak sınıflandırılan 25 hasta ortalama yaş: 64,115,3 yıl, 56sı erkek çalışmaya dahil edildi. Tip 1 ABT, tip 2 ABT ile karşılaştırıldığında, serbest T3 ve T4 konsantrasyonları sırasıyla 5,11,6 pmolLye karşı 7,62,4 pmolL ve 29,28,8 pmolLye karşı 34,911 pmolL idi. İkinci saat radyoaktif iyot tutulumu 24. saat radyoaktif iyot tutulumu ile pozitif korelasyon gösterdi p0.005. Tedavide sırasıyla, antitiroid ilaç n:20 24 ay, glukokortikoid n:7 7,41,7 ay ve sodyum perklorat n:5 3,52 ay kullanıldı. Tip 1 ABT için ilk tedavi seçeneği metimazol ve tip 2 ABT için metilprednizolon idi. Tip 2 ABT da remisyon süresi daha kısaydı p0,009. Beş hastaya radyoaktif iyot tedavisi, bir hastaya tiroidektomi uygulandı. Sonuç: Amiodaron ile indüklenen tirotoksikozların yönetimi zordur. Bu hastaların tekrar amiodarona ihtiyaç duyabileceği akılda tutulmalı, bu nedenle ihtiyaç halinde ablatif tedaviler planlanmalıdır.

Article Details

RETROSPECTIVE EVALUATION OF DIAGNOSTIC METHODS AND TREATMENT OPTIONS IN AMIODARONE-INDUCED THYROTOXICOSIS

Authors:

Nezahat Müge Çatıkkaş | Hülya Hacişahinoğulları | Nurdan Gül | Özlem Soyluk Selçukbiricik | Ferihan Aral | Refik Tanakol | Ayşe Kubat Üzüm

Publisher:

Istanbul University

Main Topics:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Journal:

İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 3, pp.227-234

Document Type:

Article

Publication Date:

10/2023

Document Language:

English

Document ID (Org No.):

2001293735

pISSN:

1305-6441

Amiodarone induced thyrotoxicosis

methimazole

methylprednisolone

perchlorateAmiodaron tirotoksikozu

metimazol

metilprednizolon

perklorat

Issues

Article Details

Authors: Nezahat Müge Çatıkkaş | Hülya Hacişahinoğulları | Nurdan Gül | Özlem Soyluk Selçukbiricik | Ferihan Aral | Refik Tanakol | Ayşe Kubat Üzüm

Publisher: Istanbul University

Main Topics: Sağlık Hizmetleri ve Sistemleri (Diğer)

Journal: İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 3, pp.227-234

Document Type: Article

Publication Date: 10/2023

Document Language: English

Document ID (Org No.): 2001293735

pISSN: 1305-6441

Issues

Authors:

Nezahat Müge Çatıkkaş | Hülya Hacişahinoğulları | Nurdan Gül | Özlem Soyluk Selçukbiricik | Ferihan Aral | Refik Tanakol | Ayşe Kubat Üzüm

Publisher:

Istanbul University

Main Topics:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Journal:

İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 3, pp.227-234

Document Type:

Article

Publication Date:

10/2023

Document Language:

English

Document ID (Org No.):

2001293735

pISSN:

1305-6441