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amiodarone induced hypothyroidism

Zdeňka Límanová, Jan Jiskra
Cardiovascular system is essentially affected by thyroid hormones by way of their genomic and non-genomic effects. Untreated overt thyroid dysfunction is associated with higher cardiovascular risk. Although it has been studied more than 3 decades, in subclinical thyroid dysfunction the negative effect on cardiovascular system is much more controversial. Large meta-analyses within last 10 years have shown that subclinical hyperthyroidism is associated with higher cardiovascular risk than subclinical hypothyroidism...
2016: Vnitr̆ní Lékar̆ství
Li-Qin Jiang, Shan-Jiang Chen, Jian-Jiang Xu, Zhang Ran, Wang Ying, Sheng-Gang Zhao
BACKGROUND/AIMS: Amiodarone, a thyroid hormone-like molecule, can induce dyslipidemia and thyroid dysfunction. However, the effects of dronedarone on lipid metabolism and of both dronedarone and amiodarone on thyroid function and lipid metabolism remain unknown. METHODS: Fifty male Sprague-Dawley rats were randomly divided into 5 groups (10 in each group): normal control (NC), amiodarone-treated (AMT), dronedarone-treated (DRT), rats treated with amiodarone combined with polyene phosphatidylcholine (AC), and rats treated with dronedarone combined with polyene phosphatidylcholine (DC)...
2016: Cellular Physiology and Biochemistry
Agata Czarnywojtek, Maria Teresa Płazińska, Małgorzata Zgorzalewicz-Stachowiak, Kosma Woliński, Adam Stangierski, Izabela Miechowicz, Joanna Waligórska-Stachura, Paweł Gut, Leszek Królicki, Maja Zioncheck, Marek Ruchała
AIM: This study aims to explore and compare the efficacy of radioiodine treatment (RIT) in hyperthyroid and euthyroid patients who have been treated with amiodarone (AM) in the past or are currently undergoing AM treatment. Clinical observation of a group of patients with amiodarone-induced hypothyroidism during a 12-month follow-up period was used for comparison. DESIGN: This was a observational, two-centered study. Patients were assessed at baseline and at 2 months, 6 months, 8 months, and 12 months after RIT...
2016: Therapeutics and Clinical Risk Management
Bin Zhong, Yazhu Wang, Guo Zhang, Zhe Wang
OBJECTIVES: To investigate the incidence of new-onset amiodarone-induced hypothyroidism (AIH) and the associated risk factors. METHODS: We performed a systematic search in MEDLINE, Embase, the Cochrane Library and the Chinese database from 1995 to 2015. Studies that investigated amiodarone-related adverse reactions on the thyroid were included. A random-effect model was used for the meta-analysis to investigate the incidence rate of AIH and associated risk factors...
2016: Cardiology
Robert Krysiak, Małgorzata Gilowska, Witold Szkróbka, Bogusław Okopień
BACKGROUND: Chronic metformin treatment was found to reduce elevated thyrotropin levels. Amiodarone treatment is associated with a range of effects in thyroid function from mild derangements to overt thyroid dysfunction. No previous study has investigated the effect of metformin on hypothalamic-pituitary-thyroid axis activity in patients with amiodarone-induced hypothyroidism. METHODS: The study included three age-, sex- and weight-matched groups of amiodarone-treated patients with type 2 diabetes: patients with treated overt hypothyroidism (group I, n=15), patients with untreated subclinical hypothyroidism (group II, n=15), and subjects without thyroid disorders (group III, n=18)...
April 2016: Pharmacological Reports: PR
Monika Różycka-Kosmalska, Renata Michalak, Marcin Kosmalski, Paweł Ptaszyński, Jerzy Krzysztof Wranicz, Wojciech Zieleniewski, Iwona Cygankiewicz
Amiodarone is an antiarrhythmic drug frequently used in everyday clinical practice. Its mechanism of action involves the interaction with many receptors, including those in the cardiac conduction system. Amiodarone usefulness is protect in the treatment of a variety of tachyarrhythmias, both benign and life-threatening. In contrast to other antiarrhythmic drugs, amiodarone is characterized by high therapeutic efficacy, both in patients with normal and impaired left ventricular systolic function. A significant limitation of its is associated with side effects including thyroid gland dysfunction...
January 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Agata Czarnywojtek, Barbara Czarnocka, Małgorzata Zgorzalewicz-Stachowiak, Kosma Wolinski, Marta Fichna, Maria Teresa Plazinska, Adam Stangierski, Pawel Gut, Izabela Miechowicz, Hanna Komarowska, Joanna Waligorska-Stachura, Ryszard Wasko, Marek Ruchala
OBJECTIVE: It has been reported that patients experiencing side effects of amiodarone (AM) therapy, such as amiodarone-induced thyrotoxocosis (AIT) or amiodarone-induced hypothyroidism (AIH), have changes in serum concentrations of anti-TSH receptor (TSHR), antithyroglobulin (Tg), and antiperoxidase (TPO) autoantibodies (Abs). The purpose of our study was to identify and analyze the changes in levels of listed antibodies in patients with several thyroid disorders. METHODS: 280 patients from two centers in Poland were included...
December 2015: Neuro Endocrinology Letters
Salwan Maqdasy, Marie Batisse-Lignier, Candy Auclair, Françoise Desbiez, Bernard Citron, Philippe Thieblot, Béatrice Roche, Jean René Lusson, Igor Tauveron
Reintroduction of amiodarone in patients with a history of amiodarone-induced thyrotoxicosis (AIT) is rarely used. To date, the risk of AIT recurrence after amiodarone reintroduction is unpredicted. The aim of the study was to evaluate the risk of AIT recurrence. Retrospectively, from 2000 to 2011, all euthyroid patients with a history of AIT with amiodarone reintroduction were included. Type and severity of the first AIT, amiodarone chronology, and thyroid function evolution after reintroduction of amiodarone were investigated: 46 of 172 patients with AIT history needed amiodarone reintroduction...
April 1, 2016: American Journal of Cardiology
L Tomisti, C Urbani, G Rossi, F Latrofa, C Sardella, L Manetti, I Lupi, C Marcocci, L Bartalena, O Curzio, E Martino, F Bogazzi
PURPOSE: It is widely accepted that type 2 amiodarone-induced thyrotoxicosis (AIT) generally occurs in patients with a normal thyroid gland without signs of thyroid autoimmunity. However, it is currently unknown if the presence of anti-thyroglobulin (TgAb) and/or anti-thyroperoxidase antibodies (TPOAb) in AIT patients without other signs of an underlying thyroid disease may impair the response to glucocorticoid therapy. METHODS: We performed a pilot retrospective cohort study with matched-subject design and an equivalence hypothesis, comparing the response to glucocorticoid therapy between 20 AIT patients with a normal thyroid gland, low radioiodine uptake, undetectable TSH receptor antibodies and positive TgAb and/or TPOAb (Ab+ group), and 40 patients with the same features and absent thyroid antibodies (Ab- group)...
May 2016: Journal of Endocrinological Investigation
Aikaterini Theodoraki, Mark P J Vanderpump
Amiodarone is an anti-arrhythmic drug that commonly affects the thyroid, causing hypothyroidism or thyrotoxicosis. Amiodarone-induced thyrotoxicosis (AIT) is caused by excessive thyroid hormone biosynthesis in response to iodine load in autonomously functioning thyroid glands with pre-existing nodular goitre or underlying Graves' disease (type 1 or AIT 1), or by a destructive thyroiditis typically occurring in normal glands (type 2 or AIT 2). Indeterminate or mixed forms are also recognised. The distinction is clinically useful as AIT 1 is treated predominantly with thionamides, whereas AIT 2 is managed with glucocorticoids...
December 7, 2015: Clinical Endocrinology
Guillermo A Keller, Paulino A Alvarez, Marcelo L Ponte, Waldo H Belloso, Claudia Bagnes, Cecilia Sparanochia, Claudio D Gonzalez, M Cecilia Villa Etchegoyen, Roberto A Diez, Guillermo Di Girolamo
OBJECTIVE: The actual prevalence of drug induced QTc prolongation in clinical practice is unknown. Our objective was to determine the occurrence and characteristics of drug-induced QT prolongation in several common clinical practices. Additionally, a subgroup of patients treated with dextropropoxyphene of particular interest for the regulatory authority was analysed. RESEARCH DESIGN AND METHODS: Medical history and comorbidities predisposing to QT interval prolongation were registered for 1270 patient requiring medical assistance that involved drug administration...
2016: Current Drug Safety
Tomislav Jukić, Marija Punda, Maja Franceschi, Josip Staniĉić, Roko Granić, Zvonko Kusić
Amiodarone is a benzofuran derivative that contains up to 40% of iodine. Amiodarone is used for treatment and prevention of life threatening supraventricular and ventricular tachyarrhythmias. The effects on thyroid gland vary from abnormalities in thyroid function tests to overt amiodarone induced hypothyroidism (AIH) and thyrotoxicosis (AIT). Patients with AIH are treated with L-thyroxine and may continue treatment with amiodarone. Two different forms of AIT have to be distinguished: amiodarone induced hyperthyroidism (AIT I) and thyroiditis (AIT II)...
May 2015: Lijec̆nic̆ki Vjesnik
Daiji Takeuchi, Kei Honda, Tokuko Shinohara, Kei Inai, Keiko Toyohara, Toshio Nakanishi
BACKGROUND: Although amiodarone (AMD)-induced thyroid dysfunction (AITD) is an important complication of AMD therapy, little is known about AITD in adult Japanese patients with congenital heart disease (CHD). METHODS AND RESULTS: We retrospectively studied 131 adult patients with CHD who were on low-dose AMD (median, 150 mg/day). The median patient age was 28 years, and the median follow-up was 44 months. The incidence, clinical course, and risk factors of AITD, including AMD-induced thyrotoxicosis (AIT) and AMD-induced hypothyroidism (AIH), were evaluated...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Agata Jabrocka-Hybel, Tomasz Bednarczuk, Luigi Bartalena, Dorota Pach, Marek Ruchała, Grzegorz Kamiński, Marta Kostecka-Matyja, Alicja Hubalewska-Dydejczyk
Amiodarone, a benzofuranic iodine-rich antiarrhythmic drug, causes thyroid dysfunction in 15-20% of cases. Amiodarone can cause both hypothyroidism (AIH, amiodarone-induced hypothyroidism) and thyrotoxicosis (AIT, amiodarone-induced thyrotoxicosis). AIH is treated by L-thyroxin replacement and does not need amiodarone discontinuation. There are two main forms of AIT: type 1, a form of true iodine-induced hyperthyroidism; and type 2, a drug-induced destructive thyroiditis. However, mixed/indefinite forms exist, contributed to by both pathogenic mechanisms...
2015: Endokrynologia Polska
Nicole Pratt, Esther W Chan, Nam-Kyong Choi, Michio Kimura, Tomomi Kimura, Kiyoshi Kubota, Edward Chia-Cheng Lai, Kenneth K C Man, Nobuhiro Ooba, Byung-Joo Park, Tsugumichi Sato, Ju-Young Shin, Ian C K Wong, Yea-Huei Kao Yang, Elizabeth E Roughead
BACKGROUND: Prescription sequence symmetry analysis (PSSA) is a signal detection method for adverse drug events. Its capacity to consistently detect adverse drug events across different settings has not been tested. We aimed to determine the consistency of PSSA results for detecting positive and negative control adverse drug events across different settings. METHODS: Using a distributed network model, we analyzed prescription dispensing data using PSSA in Australia, Hong Kong, Japan, Korea, and Taiwan...
August 2015: Pharmacoepidemiology and Drug Safety
L Brescia, A Benoit, D Betea, P Delvenne, E Hamoir, A Beckers
Amiodarone is an antiarrhythmic agent among the I most powerful and the most frequently used for the control of recurrent ventricular tachycardia and the secondary prevention of recurrent atrial fibrillation. Its use is not without risk. Although highly effective, it may induce various, sometimes severe, side effects, particularly at the thyroid level.In patients receiving amiodarone, one can encounter biological changes without clinical repercussion. Some may present a true thyroid disease, either hyper- or hypothyroidism...
October 2014: Revue Médicale de Liège
Umang Barvalia, Barkha Amlani, Ram Pathak
Amiodarone is an iodine-based, potent antiarrhythmic drug bearing a structural resemblance to thyroxine (T4). It is known to produce thyroid abnormalities ranging from abnormal thyroid function testing to overt hypothyroidism or hyperthyroidism. These adverse effects may occur in patients with or without preexisting thyroid disease. Amiodarone-induced thyrotoxicosis (AIT) is a clinically recognized condition commonly due to iodine-induced excessive synthesis of thyroid, also known as type 1 AIT. In rare instances, AIT is caused by amiodarone-induced inflammation of thyroid tissue, resulting in release of preformed thyroid hormones and a hyperthyroid state, known as type 2 AIT...
2014: Case Reports in Medicine
C A Capone, J Gebb, P Dar, R U Shenoy
Fetal supraventricular tachycardia (SVT), characterized by a fetal ventricular heart rate faster than 200 beats per minute (bpm), is often diagnosed during routine fetal heart monitoring or prenatal ultrasound examinations. Clinical guidelines for management of fetal SVT have not been determined in standardized trials, nor do we have a clear sense regarding the long-term developmental outcomes and side effects of in utero antiarrhythmic therapy. We describe our approach to the treatment of refractory SVT in a fetus with hydrops using direct umbilical vein treatment with amiodarone coupled with effusion evacuation...
2014: Journal of Neonatal-perinatal Medicine
Hernando Vargas-Uricoechea, Anilsa Bonelo-Perdomo, Carlos Hernán Sierra-Torres
Thyroid hormones have a significant impact on heart function, mediated by genomic and non-genomic effects. Consequently, thyroid hormone deficiencies, as well as excesses, are expected to result in profound changes in cardiac function regulation and cardiovascular hemodynamics. Thyroid hormones upregulate the expression of the sarcoplasmic reticulum calcium-activated ATPase and downregulate the expression of phospholamban. Overall, hyperthyroidism is characterized by an increase in resting heart rate, blood volume, stroke volume, myocardial contractility, and ejection fraction...
November 2014: Clínica e Investigación en Arteriosclerosis
Hernando Vargas-Uricoechea, Carlos Hernán Sierra-Torres
Thyroid hormones have a significant impact on heart function, mediated by genomic and non-genomic effects. Consequently, thyroid hormones deficit as well as excess are expected to result in profound changes in cardiac function regulation and cardiovascular hemodynamics. Thyroid hormones upregulate the expression of the sarcoplasmic reticulum calcium-activated ATPase and downregulate the expression of phospholamban. Overall, hyperthyroidism is characterized by an increase in resting heart rate, blood volume, stroke volume, myocardial contractility, and ejection fraction...
April 2014: Hormone Molecular Biology and Clinical Investigation
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