DR Medhat MRCP

Amiodarone-induced thyroid disease
- Amiodarone can cause hyperthyroidism or hypothyroidism
A. Amiodarone-induced hyperthyroidism
AE
Type - 1 Type - 2
Occurs in patients with
underlying thyroid pathology,
such as a nodular goitre or
Graves disease
Amiodarone contains a
significant amount of iodine,
which results in increased
thyroid hormone synthesis
Occurs in patients without
underlying thyroid pathology.
Amiodarone causing a subacute
thyroiditis with release of
preformed thyroid hormones into
the circulation.
This is a direct toxic effect on the
thyroid follicular cells
Thyrotoxic phase for weeksmonths
followed by hypothyroid
phase then recovery
Epidem. Often seen in iodine-deficienct
areas
Most common in Europe and
North America
Diagnosis Normal or high I 131 uptake Minimal or absent I 131 uptake
High IL-6
TTT Thionamide (main TTT)
K-perchlorate
lithium
Prednisone for 2-3 months.