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A Case-Based Guide to Clinical EndocrinologyAmiodarone-Induced Hypothyroidism

A Case-Based Guide to Clinical Endocrinology: Amiodarone-Induced Hypothyroidism Chapter 8 Ramzi Ajjan Objectives To discuss the difficulties encountered in the management of patients with Case Presentation A 34-year-old man with a diagnosis of dilated cardiomyopathy following myocardi- tis was commenced on amiodarone in February 1994 by the cardiologist as a treatment for narrow and broad complex tachycardia secondary to His-bundle arrhythmia. He was started on 600 mg amiodarone/day for 1 week, 400 mg/day for another week, followed by 200 mg/day as a maintenance dose. The rest of his treatment included bisoprolol 10 mg once/day and enalapril 10 mg twice/day. His thyroid function tests (TFTs) were not requested prior to initiating amiodarone but 4 weeks after starting treatment these showed: total T (TT ), 74 nmol/L (normal 4 4 range, 60–140), and thyroid-stimulating hormone (TSH), 6.51 mU/L (normal range, 0.2–4.0). The patient was reviewed in July 1994, when he was complaining of tiredness and his TFTs showed TT of 92 nmol/L and TSH of 2.18 mU/L. Tiredness was attributed to his heart failure, and the patient was followed up for the next 18 months with regular TFTs, which were all normal. In September 1995 the TSH rose to 9.8 mU/L with a normal TT of 93 nmol/L. In http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyAmiodarone-Induced Hypothyroidism

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Ajjan, Ramzi
Springer Journals — Jan 1, 2008
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Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
77 –83
DOI
10.1007/978-1-60327-103-5_8
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 8 Ramzi Ajjan Objectives To discuss the difficulties encountered in the management of patients with Case Presentation A 34-year-old man with a diagnosis of dilated cardiomyopathy following myocardi- tis was commenced on amiodarone in February 1994 by the cardiologist as a treatment for narrow and broad complex tachycardia secondary to His-bundle arrhythmia. He was started on 600 mg amiodarone/day for 1 week, 400 mg/day for another week, followed by 200 mg/day as a maintenance dose. The rest of his treatment included bisoprolol 10 mg once/day and enalapril 10 mg twice/day. His thyroid function tests (TFTs) were not requested prior to initiating amiodarone but 4 weeks after starting treatment these showed: total T (TT ), 74 nmol/L (normal 4 4 range, 60–140), and thyroid-stimulating hormone (TSH), 6.51 mU/L (normal range, 0.2–4.0). The patient was reviewed in July 1994, when he was complaining of tiredness and his TFTs showed TT of 92 nmol/L and TSH of 2.18 mU/L. Tiredness was attributed to his heart failure, and the patient was followed up for the next 18 months with regular TFTs, which were all normal. In September 1995 the TSH rose to 9.8 mU/L with a normal TT of 93 nmol/L. In

Published: Jan 1, 2008

Keywords: Thyroid Autoimmunity; Subclinical Hypothyroidism; Thyroid Function Test; Thyroid Status; Thyroid Follicular Cell

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