Amiodarone-induced hyperthyroidism: assessment of the predictive value of biochemical testing and response to combined therapy using propylthiouracil and potassium perchlorate.

摘要: : In order to assess the value of thyroid function testing during amiodarone therapy, we reviewed all available tests in 128 patients treated with this drug. Nine (7.0%) developed biochemical hyperthyroidism elevation both free thyroxine index (FT4I) and triiodothyronine (FT3I) marked suppression serum stimulating hormone (TSH) after 1–46 months therapy; six these nine had clear clinical evidence overactivity. Where serial were before development hyperthyroidism, complication suddenly, despite previously stable normal indices function, could not be predicted by currently-available such as T4, T3, sensitive TSH, thyroglobulin or sex binding globulin (SHBG) assays. Clinical features unexplained weight loss, proximal myopathy, exacerbation arrhythmia, heat intolerance appear key prompt diagnosis complication. Hyperthyroxinemia without T3 excess was found 32.8% progression true hyperthyroidism. Serum TSH remained detectable assay 17 out 18 amiodarone-induced euthyroid hyperthyroxinemia significantly higher than equivalent due therapy. Serial levels SHBG those hyperthyroxinemia. The effect combined treatment propylthiouracil (800 mg/day) potassium perchlorate evaluated five clinically hyperthyroid patients. Biochemical euthyroidism achieved 7–19 weeks, a response slower reported, indicating that drug combination does result uniformly resolution (Aust N2 J Med 1987; 18: 37–44.)