Amiodarone-induced thyrotoxicosis type 2: predictors and treatment options

Cover Page


Cite item

Full Text

Abstract

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.

About the authors

A. S. Ermolaeva

I.M. Sechenov First Moscow State Medical
University

Author for correspondence.
Email: a.s.arkhipova@inbox.ru

Alexandra S. Ermolaeva – Postgraduate Student, Department of Endocrinology No. 1, Medical Faculty,

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

O. A. Biakina

I.M. Sechenov First Moscow State Medical
University

Email: fake@neicon.ru

Olga A. Biakina – Postgraduate Student, Department of Preventive and Emergency Cardiology, Medical Faculty,

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

J. P. Sytch

I.M. Sechenov First Moscow State Medical
University

Email: fake@neicon.ru

Julia P. Sytch – MD, PhD, Assistant, Department of Endocrinology No. 1, Medical Faculty,

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

P. Yu. Kopylov

I.M. Sechenov First Moscow State Medical
University

Email: fake@neicon.ru

Phillip Yu. Kopylov – MD, PhD, Professor, Department of Preventive and Emergency Cardiology, Medical Faculty,

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

V. V. Fadeev

I.M. Sechenov First Moscow State Medical
University

Email: fake@neicon.ru

Valentin V. Fadeev – MD, PhD, Professor, MemberCorrespondent of Russian Academy of Sciences, Head of Department of Endocrinology No. 1, Medical Faculty,

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

References

  1. Claro JC, Candia R, Rada G, Baraona F, Larrondo F, Letelier LM. Amiodarone versus other pharmacological interventions for prevention of sudden cardiac death. Cochrane Database Syst Rev. 2015;(12):CD008093. doi: 10.1002/14651858.CD008093.pub2.
  2. Laina A, Karlis G, Liakos A, Georgiopoulos G, Oikonomou D, Kouskouni E, Chalkias A, Xanthos T. Amiodarone and cardiac arrest: Systematic review and meta-analysis. Int J Cardiol. 2016;221:780–8. doi: 10.1016/j.ijcard.2016.07.138.
  3. Ortiz M, Martín A, Arribas F, Coll-Vinent B, Del Arco C, Peinado R, Almendral J; PROCAMIO Study Investigators. Randomized comparison of intravenous procainamide vs. intravenous amiodarone for the acute treatment of tolerated wide QRS tachycardia: the PROCAMIO study. Eur Heart J. 2017;38(17):1329–35. doi: 10.1093/eurheartj/ehw230.
  4. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology /American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018;72(14):e91–220. doi: 10.1016/j.jacc.2017.10.054.
  5. Сулимов ВА, Гиляров МЮ. Амиодарон: особенности клинического применения. Русский медицинский журнал. 2008;16(6): 375–81.
  6. Bartalena L, Bogazzi F, Chiovato L, Hubalewska-Dydejczyk A, Links TP, Vanderpump M. 2018 European Thyroid Association (ETA) Guidelines for the Management of Amiodarone-Associated Thyroid Dysfunction. Eur Thyroid J. 2018;7(2):55–66. doi: 10.1159/000486957.
  7. Brooks MJ, Pattison DA, Teo EP, Price S, Gurvitch R. Amiodarone-induced destructive thyroiditis associated with coronary artery vasospasm and recurrent ventricular fibrillation. Eur Thyroid J. 2013;2(1):65–7. doi: 10.1159/000345528.
  8. Kinoshita S, Hayashi T, Wada K, Yamato M, Kuwahara T, Anzai T, Fujimoto M, Hosomi K, Takada M. Risk factors for amiodarone-induced thyroid dysfunction in Japan. J Arrhythm. 2016;32(6):474–80. doi: 10.1016/j.joa.2016.03.008.
  9. Zosin I, Balaş M. Amiodarone-induced thyroid dysfunction in an iodine-replete area: epidemiological and clinical data. Endokrynol Pol. 2012;63(1):2–9.
  10. Maqdasy S, Benichou T, Dallel S, Roche B, Desbiez F, Montanier N, Batisse-Lignier M, Tauveron I. Issues in amiodarone-induced thyrotoxicosis: Update and review of the literature. Ann Endocrinol (Paris). 2019;80(1):54–60. doi: 10.1016/j.ando.2018.05.001.
  11. Uchida T, Kasai T, Takagi A, Sekita G, Komiya K, Takeno K, Shigihara N, Shimada K, Miyauchi K, Fujitani Y, Daida H, Watada H. Prevalence of amiodarone-induced thyrotoxicosis and associated risk factors in Japanese patients. Int J Endocrinol. 2014;2014:534904. doi: 10.1155/2014/534904.
  12. Bogazzi F, Bartalena L, Dell'Unto E, Tomisti L, Rossi G, Pepe P, Tanda ML, Grasso L, Macchia E, Aghini-Lombardi F, Pinchera A, Martino E. Proportion of type 1 and type 2 amiodarone-induced thyrotoxicosis has changed over a 27-year period in Italy. Clin Endocrinol (Oxf). 2007;67(4):533–7. doi: 10.1111/j.1365-2265.2007.02920.x.
  13. Крюков ЕВ, Потехин НП, Фурсов АН, Чернавский СВ, Ляпкова НБ, Захарова ЕГ, Макеева ТГ. Алгоритм ведения пациентов, получающих амиодарон, в зависимости от функционального состояния щитовидной железы. Клиническая медицина. 2017;95(10): 901–5. doi: 10.18821/0023-2149-2017-95-10-901-905.
  14. Дедов ИИ, Мельниченко ГА, Свириденко НЮ, Платонова НМ, Молашенко НВ, Егоров АВ. Диагностика, лечение и профилактика ятрогенных йодиндуцированных заболеваний щитовидной железы. Вестник РАМН. 2006;(2):15–21.
  15. Han TS, Williams GR, Vanderpump MP. Benzofuran derivatives and the thyroid. Clin Endocrinol (Oxf). 2009;70(1):2–13. doi: 10.1111/j.1365-2265.2008.03350.x.
  16. Basaria S, Cooper DS. Amiodarone and the thyroid. Am J Med. 2005;118(7):706–14. doi: 10.1016/j.amjmed.2004.11.028.
  17. Trohman RG, Sharma PS, McAninch EA, Bianco AC. Amiodarone and the thyroid physiology, pathophysiology, diagnosis and management. Trends Cardiovasc Med. 2018. pii: S1050-1738(18)30195-6. doi: 10.1016/j.tcm.2018.09.005.
  18. Свириденко НЮ, Платонова НМ, Молашенко НВ, Голицин СП, Бакалов СА, Сердюк СЕ. Эндокринные аспекты применения амиодарона в клинической практике (алгоритм наблюдения и лечения функциональных расстройств щитовидной железы). Российский кардиологический журнал. 2012;(2):63–71. doi: 10.15829/1560-4071-2012-2-63-71.
  19. Różycka-Kosmalska M, Michalak R, Kosmalski M, Ptaszyński P, Wranicz JK, Zieleniewski W, Cygankiewicz I. Clinical procedure in amiodarone-induced thyroid dysfunction. Pol Merkur Lekarski. 2016;40(235):46–52.
  20. Diederichsen SZ, Darkner S, Chen X, Johannesen A, Pehrson S, Hansen J, Feldt-Rasmussen U, Svendsen JH. Short-term amiodarone treatment for atrial fibrillation after catheter ablation induces a transient thyroid dysfunction: Results from the placebo-controlled, randomized AMIO-CAT trial. Eur J Intern Med. 2016;33:36–41. doi: 10.1016/j.ejim.2016.04.012.
  21. van Beeren HC, Kwakkel J, Ackermans MT, Wiersinga WM, Fliers E, Boelen A. Action of specific thyroid hormone receptor α(1) and β(1) antagonists in the central and peripheral regulation of thyroid hormone metabolism in the rat. Thyroid. 2012;22(12):1275–82. doi: 10.1089/thy.2012.0135.
  22. Bogazzi F, Tomisti L, Di Bello V, Martino E. Amiodarone-induced thyrotoxicosis. G Ital Cardiol (Rome). 2017;18(3):219–29. doi: 10.1714/2674.27399.
  23. Lombardi A, Inabnet WB 3rd, Owen R, Farenholtz KE, Tomer Y. Endoplasmic reticulum stress as a novel mechanism in amiodarone-induced destructive thyroiditis. J Clin Endocrinol Metab. 2015;100(1):E1–10. doi: 10.1210/jc.2014-2745.
  24. Tedelind S, Larsson F, Johanson C, van Beeren HC, Wiersinga WM, Nyström E, Nilsson M. Amiodarone inhibits thyroidal iodide transport in vitro by a cyclic adenosine 5'-monophosphate- and iodine-independent mechanism. Endocrinology. 2006;147(6):2936–43. doi: 10.1210/en.2005-1246.
  25. Vergara-Jaque A, Fong P, Comer J. Iodide binding in sodium-coupled cotransporters. J Chem Inf Model. 2017;57(12):3043–55. doi: 10.1021/acs.jcim.7b00521.
  26. Karbownik-Lewińska M, Kokoszko-Bilska A. Oxidative damage to macromolecules in the thyroid – experimental evidence. Thyroid Res. 2012;5(1):25. doi: 10.1186/1756-6614-5-25.
  27. Zoidis E, Seremelis I, Kontopoulos N, Danezis GP. Selenium-dependent antioxidant enzymes: actions and properties of selenoproteins. Antioxidants (Basel). 2018;7(5). pii: E66. doi: 10.3390/antiox7050066.
  28. He L, He T, Farrar S, Ji L, Liu T, Ma X. Antioxidants maintain cellular redox homeostasis by elimination of reactive oxygen species. Cell Physiol Biochem. 2017;44(2):532–53. doi: 10.1159/000485089.
  29. Weber G, Rabbiosi S, Zamproni I, Fugazzola L. Genetic defects of hydrogen peroxide generation in the thyroid gland. J Endocrinol Invest. 2013;36(4):261–6. doi: 10.3275/8847.
  30. Ahmed S, Van Gelder IC, Wiesfeld AC, Van Veldhuisen DJ, Links TP. Determinants and outcome of amiodarone-associated thyroid dysfunction. Clin Endocrinol (Oxf). 2011;75(3):388–94. doi: 10.1111/j.1365-2265.2011.04087.x.
  31. Gopalan M, Burks J, Talavera F, Chausmer AB, Khardori R, Gabbay RA. Thyroid dysfunction induced by amiodarone. Updated: Oct 08, 2018 [Internet]. Available from: https://emedicine.medscape.com/article/129033-overview.
  32. Takeuchi D, Honda K, Shinohara T, Inai K, Toyohara K, Nakanishi T. Incidence, clinical course, and risk factors of amiodarone-induced thyroid dysfunction in Japanese adults with congenital heart disease. Circ J. 2015;79(8):1828– 34. doi: 10.1253/circj.CJ-15-0042.
  33. Narayana SK, Woods DR, Boos CJ. Management of amiodarone-related thyroid problems. Ther Adv Endocrinol Metab. 2011;2(3):115–26. doi: 10.1177/2042018811398516.
  34. Shinohara T, Takahashi N. How long should we check thyroid function after amiodarone withdrawal? Circ J. 2013;77(12):2875–6. doi: 10.1253/circj.CJ-13-1242.
  35. Bogazzi F, Tomisti L, Bartalena L, Aghini-Lombardi F, Martino E. Amiodarone and the thyroid: a 2012 update. J Endocrinol Invest. 2012;35(3):340–8. doi: 10.3275/8298.
  36. Stan MN, Ammash NM, Warnes CA, Brennan MD, Thapa P, Nannenga MR, Bahn RS. Body mass index and the development of amiodarone-induced thyrotoxicosis in adults with congenital heart disease – a cohort study. Int J Cardiol. 2013;167(3):821–6. doi: 10.1016/j.ijcard.2012.02.015.
  37. Yamato M, Wada K, Hayashi T, Fujimoto M, Hosomi K, Oita A, Takada M. Association between serum amiodarone and n-desethylamiodarone concentrations and development of thyroid dysfunction. Clin Drug Investig. 2018;38(1):39–48. doi: 10.1007/s40261-017-0582-4.
  38. Tsadok MA, Jackevicius CA, Rahme E, Essebag V, Eisenberg MJ, Humphries KH, Tu JV, Behlouli H, Joo J, Pilote L. Amiodarone-induced thyroid dysfunction: brand-name versus generic formulations. CMAJ. 2011;183(12):E817– 23. doi: 10.1503/cmaj.101800.
  39. Hen K, Czarnywojtek A, Stangierski A, Warmuz-Stangierska I, Zdanowska J, Florek E, Ruchała M. Effect of amiodarone on the thyroid function and safety of the therapy – what's new. Przegl Lek. 2012;69(10):1135–9.
  40. Yamamoto JM, Katz PM, Bras JAF, Shafer LA, Leung AA, Ravandi A, Cordova FJ. Amiodarone-induced thyrotoxicosis in heart failure with a reduced ejection fraction: A retrospective cohort study. Health Sci Rep. 2018;1(5):e36. doi: 10.1002/hsr2.36.
  41. Платонова НМ. Современные аспекты диагностики и лечения амиодарон-индуцированного тиреотоксикоза. Поликлиника. 2016;(1–2):45–50.
  42. Tomisti L, Urbani C, Rossi G, Latrofa F, Sardella C, Manetti L, Lupi I, Marcocci C, Bartalena L, Curzio O, Martino E, Bogazzi F. The presence of anti-thyroglobulin (TgAb) and/or anti-thyroperoxidase antibodies (TPOAb) does not exclude the diagnosis of type 2 amiodarone-induced thyrotoxicosis. J Endocrinol Invest. 2016;39(5):585–91. doi: 10.1007/s40618-015-0426-0.
  43. Theodoraki A, Vanderpump MPJ. Thyrotoxicosis associated with the use of amiodarone: the utility of ultrasound in patient management. Clin Endocrinol (Oxf). 2016;84(2):172–6. doi: 10.1111/cen.12988.
  44. Wang J, Zhang R. Evaluation of 99mTc-MIBI in thyroid gland imaging for the diagnosis of amiodarone-induced thyrotoxicosis. Br J Radiol. 2017;90(1071):20160836. doi: 10.1259/bjr.20160836.
  45. Censi S, Bodanza V, Manso J, Gusella S, Watutantrige-Fernando S, Cavedon E, Barollo S, Bertazza L, Cecchin D, Mian C. Amiodarone-Induced Thyrotoxicosis: Differential Diagnosis Using 99mTc-SestaMIBI and Target-to-Background Ratio (TBR). Clin Nucl Med. 2018;43(9): 655–62. doi: 10.1097/RLU.0000000000002207.
  46. Tauveron I, Batisse-Lignier M, Maqdasy S. Challenges in the management of amiodarone-induced thyrotoxicosis. Presse Med. 2018;47(9): 746–56. doi: 10.1016/j.lpm.2018.09.001.
  47. Мельниченко ГА, Ларина ИИ. Синдром тиреотоксикоза. Дифференциальная диагностика и лечение. Терапевтический архив. 2018;90(10):4–13. doi: 10.26442/terarkh201890104-13.
  48. Fumarola A, Di Fiore A, Dainelli M, Grani G, Calvanese A. Medical treatment of hyperthyroidism: state of the art. Exp Clin Endocrinol Diabetes. 2010;118(10):678–84. doi: 10.1055/s0030-1253420.
  49. Eskes SA, Endert E, Fliers E, Geskus RB, Dullaart RP, Links TP, Wiersinga WM. Treatment of amiodarone-induced thyrotoxicosis type 2: a randomized clinical trial. J Clin Endocrinol Metab. 2012;97(2):499–506. doi: 10.1210/jc.2011-2390.
  50. Bogazzi F, Bartalena L, Tomisti L, Rossi G, Tanda ML, Dell'Unto E, Aghini-Lombardi F, Martino E. Glucocorticoid response in amiodarone-induced thyrotoxicosis resulting from destructive thyroiditis is predicted by thyroid volume and serum free thyroid hormone concentrations. J Clin Endocrinol Metab. 2007;92(2):556–62. doi: 10.1210/jc.2006-2059.
  51. Conen D, Melly L, Kaufmann C, Bilz S, Ammann P, Schaer B, Sticherling C, Muller B, Osswald S. Amiodarone-induced thyrotoxicosis: clinical course and predictors of outcome. J Am Coll Cardiol. 2007;49(24):2350–5. doi: 10.1016/j.jacc.2007.02.054.
  52. Sato K, Shiga T, Matsuda N, Onoda N, Takano K, Hagiwara N, Kasanuki H. Mild and short recurrence of type II amiodarone-induced thyrotoxicosis in three patients receiving amiodarone continuously for more than 10 years. Endocr J. 2006;53(4):531–8. doi: 10.1507/endocrj.K06-027.
  53. Jabrocka-Hybel A, Bednarczuk T, Bartalena L, Pach D, Ruchała M, Kamiński G, Kostecka-Matyja M, Hubalewska-Dydejczyk A. Amiodarone and the thyroid. Endokrynol Pol. 2015;66(2): 176–86. doi: 10.5603/EP.2015.0025.
  54. Tyer NM, Kim TY, Martinez DS. Review of oral cholecystographic agents for the management of hyperthyroidism. Endocr Pract. 2014;20(10):1084–92. doi: 10.4158/EP14024.RA.
  55. Matrka L, Steward D, Falciglia M, Nikiforov Y. Pharmacodynamic effect of iopanoic acid on free T(3) and T(4) levels in amiodarone-induced thyrotoxicosis. Ear Nose Throat J. 2008;87(12): 702–4.
  56. Bogazzi F, Bartalena L, Cosci C, Brogioni S, Dell'Unto E, Grasso L, Aghini-Lombardi F, Rossi G, Pinchera A, Braverman LE, Martino E. Treatment of type II amiodarone-induced thyrotoxicosis by either iopanoic acid or glucocorticoids: a prospective, randomized study. J Clin Endocrinol Metab. 2003;88(5):1999–2002. doi: 10.1210/jc.2002-021874.
  57. Durukan AB, Erdem B, Durukan E, Sevim H, Karaduman T, Gurbuz HA, Gurpinar A, Yorgancioglu C. May toxicity of amiodarone be prevented by antioxidants? A cell-culture study. J Cardiothorac Surg. 2012;7:61. doi: 10.1186/1749-8090-7-61.
  58. Zickri MB, Embaby A. Relation between Endogenous Stem Cells and Green Tea Extract in Overconsumption and Amiodarone Induced Thyroid Damage in Rat. Int J Stem Cells. 2013;6(2):113–20.
  59. Yamamoto J, Dostmohamed H, Schacter I, Ariano RE, Houston DS, Lewis B, Knoll C, Katz P, Zarychanski R. Preoperative therapeutic apheresis for severe medically refractory amiodarone-induced thyrotoxicosis: a case report. J Clin Apher. 2014;29(3):168–70. doi: 10.1002/jca.21309.
  60. Schwartz J, Winters JL, Padmanabhan A, Balogun RA, Delaney M, Linenberger ML, Szczepiorkowski ZM, Williams ME, Wu Y, Shaz BH. Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: the sixth special issue. J Clin Apher. 2013;28(3):145–284. doi: 10.1002/jca.21276.
  61. Zhu L, Zainudin SB, Kaushik M, Khor LY, Chng CL. Plasma exchange in the treatment of thyroid storm secondary to type II amiodarone-induced thyrotoxicosis. Endocrinol Diabetes Metab Case Rep. 2016;2016:160039. doi: 10.1530/EDM-16-0039.
  62. Gursoy A, Tutuncu NB, Gencoglu A, Anil C, Demirer AN, Demirag NG. Radioactive iodine in the treatment of type-2 amiodarone-induced thyrotoxicosis. J Natl Med Assoc. 2008;100(6):716–9. doi: 10.1016/S0027-9684(15)31348-1.
  63. Czarnywojtek A, Warmuz-Stangierska I, Woliński K, Płazińska M, Kobylecka M, Kunikowska J, Stangierski A, Miechowicz I, Waligórska-Stachura J, Rewers A, Królicki L, Ruchała M. Radioiodine therapy in patients with type II amiodarone-induced thyrotoxicosis. Pol Arch Med Wewn. 2014;124(12):695– 703. doi: 10.20452/pamw.2556.
  64. Czarnywojtek A, Płazińska MT, Zgorzalewicz-Stachowiak M, Woliński K, Stangierski A, Miechowicz I, Waligórska-Stachura J, Gut P, Królicki L, Zioncheck M, Ruchała M. Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases. Ther Clin Risk Manag. 2016;12:505–13. doi: 10.2147/TCRM.S96606.
  65. Isaacs M, Costin M, Bova R, Barrett HL, Heffernan D, Samaras K, Greenfield JR. Management of amiodarone-induced thyrotoxicosis at a cardiac transplantation centre. Front Endocrinol (Lausanne). 2018;9:482. doi: 10.3389/fendo.2018.00482.
  66. Kotwal A, Clark J, Lyden M, McKenzie T, Thompson G, Stan MN. Thyroidectomy for amiodarone-induced thyrotoxicosis: Mayo Clinic experience. J Endocr Soc. 2018;2(11):1226–35. doi: 10.1210/js.2018-00259.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2019 Ermolaeva A.S., Biakina O.A., Sytch J.P., Kopylov P.Y., Fadeev V.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies