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Hypothyroidism is more frequent after thyroid inflammation induced by amiodarone than after painful subacute thyroiditis
The background of the study. Thyroid inflammation (thyroiditis) may occur in patients treated with the cardiac drug amiodarone, and it is occasionally followed by hypothyroidism. In this study, patients with amiodarone-induced thyroiditis were followed for up to six years, and the results were compared with those of patients with painful subacute thyroiditis who were followed similarly.
How the study was done. The study subjects were 60 patients with amiodarone-induced thyroiditis and 60 patients with painful subacute thyroiditis. All the patients initially had hyperthyroidism and were treated with decreasing doses of prednisone for three months. The patients were followed periodically thereafter; the average duration of follow-up was 38 months in the amiodarone-induced thyroiditis group and 40 months in the painful subacute thyroiditis group. Hypothyroidism was considered permanent when a patient had high serum thyrotropin and low serum thyroxine concentrations on three consecutive occasions.
The results of the study. All patients were euthyroid after therapy with prednisone for 10 to 150 days. Subsequently, 10 patients (17 percent) in the amiodarone group and 3 patients (5 percent) in the painful subacute thyroiditis group had hypothyroidism. The patients in the amiodarone group who had hypothyroidism did not differ from those who continued to have normal thyroid function with respect to the ratio of women to men, age, initial serum thyroxine concentrations, the cumulative dose and duration of amiodarone, and time to disappearance of hyperthyroidism during prednisone therapy.
The conclusions of the study. Permanent hypothyroidism is more common after hyperthyroidism caused by amiodarone-induced thyroiditis than hyperthyroidism caused by painful subacute thyroiditis.
The original article. Bogazzi F, Dell’Unto E, Tanda ML, Tomisti L, Cosci C, Aghini-Lombardi F, Sardella C, Pinchera A, Bartalena L, Martino E. Long-term outcome of thyroid function after amiodarone-induced thyrotoxicosis, as compared to subacute thyroiditis. J Endocrinol Invest 2006;29:694-9.
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| Thyroid Digest Index | | | March 2007 Thyroid Digest |
