Vom Regen in die Traufe

Summary From bad to worse An 80-year-old male patient presented with subtle signs of thyrotoxicosis after long-term treatment with amiodarone. Antithyroid medication with thionamides and sodium perchlorate was initiated without significant clinical improvement. One month later these drugs had to be stopped due to fever with rash and eosinophilia. Subsequent administration of glucocorticoids resolved both the hyperthyroidism and the treatment complication, indicating the presence of amiodarone-associated thyrotoxicosis type 2. Amiodarone-associated thyrotoxicosis type 2 is an inflammatory destructive thyroiditis against which antithyroid drugs are ineffective.