Open AccessAmiodarone-induced thyrotoxicosis type 2: predictors and treatment options
Author(s) -
А. С. Ермолаева,
О. А. Бякина,
Ю. П. Сыч,
Ф. Ю. Копылов,
В. В. Фадеев
Publication year - 2019
Publication title -
alʹmanah kliničeskoj mediciny
Language(s) - English
Resource type - Journals
eISSN - 2587-9294
pISSN - 2072-0505
DOI - 10.18786/2072-0505-2019-47-018
Subject(s) - amiodarone , medicine , thyroiditis , drug , heart failure , medical prescription , disease , cardiology , intensive care medicine , pharmacology , atrial fibrillation
Amiodarone-induced type 2 thyrotoxicosis remains a significant problem of modern endocrinology and cardiology. The unique pharmacological character and multifaceted properties of amiodarone explain its high prescription frequency and the leading position among antiarrhythmic drugs. In its turn, cytotoxicity and supra-physiological iodine content in the drug increase the risk of drug-induced destructive thyroiditis. The development of thyrotoxicosis leads to recurrence of cardiac arrhythmias, increased left ventricular dysfunction and manifestations of chronic heart failure. Correct identification of the type of thyrotoxicosis determines the subsequent patient management strategy. Glucocorticoids have been recognized as the first-line treatment among the possible therapy options. Rapid correction of thyrotoxicosis is crucial, especially in elderly patients with severe heart disease. Of interest for practical medicine is the search for specific predictors (deep understanding of the pathogenetic mechanisms) and new possibilities of therapy for amiodarone-induced thyrotoxicosis type 2.