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Chapter 4 Paul Aoun and David S. Cooper Objectives Amiodarone is a potent antiarrhythmic drug that is associated with a wide array of adverse effects, including both hypothyroidism and hyperthyroidism. Here, we report the case of a 65-year-old man who was started on amiodarone for recurrent atrial fibrillation and 2 years later developed hyperthyroidism. We briefly review the normal changes in thyroid function tests that are seen with amiodarone. We then discuss the proposed etiologies, evaluation, and treatments of patients with amiodarone-induced thyrotoxicosis (AIT) type 1 and type 2. Case Presentation A.B. is a 65-year-old man with a past medical history of hypertension, atrial fib- rillation, and hyperlipidemia, but no history of thyroid disease. He was referred to the endocrine clinic for evaluation of probable amiodarone-induced hyperthy- roidism. Five years ago, the patient developed recurrent atrial fibrillation. After several failures of cardioversion, he was placed on amiodarone. Two years later, he noted weakness in his legs while walking or climbing stairs, and difficulty sleeping, hyperdefecation, and mild nervousness. He had no significant weight loss, palpita- tions, tremor, dysphagia, or neck pain. Prior to the initiation of amiodarone therapy and for almost the first 2 years of it, the patient
Published: Jan 1, 2008
Keywords: Thyroid Function Test; Multinodular Goiter; Antithyroid Drug; Amiodarone Therapy; Organic Iodine
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