Amiodarone-induced thyrotoxicosis type 2: predictors and treatment options

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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

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

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