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1: J Med Case Reports. 2007 Nov 13;1:134.Click here to read Click here to read Links

A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report.

Papaioannou V, Terzi I, Dragoumanis C, Konstantonis D, Theodorou V, Pneumatikos I.

Department of Intensive Care Medicine, Alexandroupolis University Hospital, Democritus University of Thrace, Medical School, Dragana, Alexandroupolis 68100, Greece. christosdragoumanis@gmail.com.

ABSTRACT: BACKGROUND: Amiodarone is a widely used antiarrythmic drug, which may produce secondary effects on the thyroid. In 14-18% of amiodarone-treated patients, there is overt thyroid dysfunction, usually in the form of amiodarone-induced thyrotoxicosis, which can be difficult to manage with standard medical treatment. CASE PRESENTATION: Presented is the case of a 65-year-old man, under chronic treatment of atrial fibrillation with amiodarone, who was admitted to the Intensive Care Unit with acute cardio-respiratory failure and fever. He was recently hospitalized with respiratory distress, attributed to amiodarone-induced pulmonary fibrosis. Clinical and laboratory investigation revealed thyrotoxicosis due to amiodarone treatment. He was begun on thionamide, prednisone and beta-blockers. After a short term improvement of his clinical status the patient underwent percutaneous tracheotomy due to weaning failure from mechanical ventilation, which led to the development of recurrent thyrotoxicosis, unresponsive to medical treatment. Finally, the patient developed multiple organ failure and died, seven days later. CONCLUSION: We suggest that percutaneous tracheotomy could precipitate a thyrotoxic crisis, particularly in non-euthyroid patients suffering from concurrent severe illness and should be performed only in parallel with emergency thyroid surgery, when indicated.

PMID: 17999752 [PubMed - in process]

PMCID: PMC2194711

Patient Drug Information

  • Thyroid (Armour® Thyroid)

    Thyroid is a hormone produced by the body. When taken correctly, thyroid is used to treat the symptoms of hypothyroidism (a condition where the thyroid gland does not produce enough thyroid hormone). Symptoms of hypothyr...

  • Prednisone (Prednisone Intensol® , Sterapred® , Sterapred® DS)

    Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednis...

  • Amiodarone (Cordarone® , Pacerone® )

    Amiodarone is used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias (a certain type of abnormal heart rhythm when other medications did not help or could not be tolerated. Amiodaron...

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