Skeletal formula of amiodarone—a class III antiarrhythmic.
Specialty
Endocrinology
Amiodarone induced thyrotoxicosis (AIT) is a form of hyperthyroidism due to treatment with antiarrhythmic drug, amiodarone.
Amiodarone induced thyroid dysfunction more commonly results in hypothyroidism, estimated to occur in 6-32% of patients, whereas hyperthyroidism from amiodarone use is estimated at 1-12%.[1] However, the prevalence of AIT varies based on geographical region, and is more common in areas with low dietary iodine intake, where it occurs in 10-12% of patients. In the United States, clinical manifestations of AIT occur in 3-5% of patients.[2]
AIT may present clinically early after initiation of amiodarone or can be delayed even up several years.[3] Symptoms associated with AIT are similar to those of other forms of hyperthyroidism, including new-onset or recurrence of arrhythmias, worsening of pre-existing heart conditions such as ischemic heart disease or heart failure, unattributed weight loss, and fever.[2][3] Development of AIT is associated with an increased risk for major adverse cardiovascular events, and increased mortality specifically in patients with AIT and underlying heart failure.[3][4]
^Goundan PN, Lee SL (October 2020). "Thyroid effects of amiodarone: clinical update". Current Opinion in Endocrinology, Diabetes, and Obesity. 27 (5): 329–334. doi:10.1097/MED.0000000000000562. PMID 32773570. S2CID 221098785.
^ abRoss DS (25 January 2022). Cooper DS, Mulder JE (eds.). "Amiodarone and thyroid dysfunction". UpToDate. Retrieved 2023-01-04.
^ abcDanzi S, Klein I (May 2015). "Amiodarone-induced thyroid dysfunction". Journal of Intensive Care Medicine. 30 (4): 179–185. doi:10.1177/0885066613503278. PMID 24067547. S2CID 21019957.
^Bartalena L, Bogazzi F, Chiovato L, Hubalewska-Dydejczyk A, Links TP, Vanderpump M (March 2018). "2018 European Thyroid Association (ETA) Guidelines for the Management of Amiodarone-Associated Thyroid Dysfunction". European Thyroid Journal. 7 (2): 55–66. doi:10.1159/000486957. PMC 5869486. PMID 29594056.
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