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Hipertiroza povzročena z amiodaronom - prikaz dveh primerov = Cordarone induced hyperthyroidism - presentation of two cases
Molnar-Novak, Helena ; Bedernjak-Bajuk, Nataša ; Hojker, Sergej
Amiodarone is a powerful antiarrhythmic drug, which is used frequently. Hyperthyroidism or hypothyroidism can be side effects. Hyperthyroidism can be a life - threatening condition and therapy is ...needed for a long period. Two patients, male and female, with dilated myocardiopathy and one with implantable cardioverter defibrillator are presented. In our first patient a severe hyperthyroidism has appeared after three years of therapy with amiodarone. Therapy with amiodarone was stopped immediately. Methimazole, perchlorate and corticosteroides in high doses were introduced at once. After four months thyroid hormones were in normal range and in next four months methimazole therapy was stopped. Thyroid hormons and TSH are normal now. The second patient has had dilated myocardiopathy and paroxysmal atrial fibrillation. After a year of therapy with amiodarone hyperthyroidism appeared. Amiodarone was at once disconnected and methimazole was included in therapy. After three months of therapy with methimazole, our patient become euthyrotic. Because of paroxysmal atrial fibrillation the serious haemodynamics side effects were confirmed. We had to continue the therapy withamiodarone. Therefore, she was treated with radioiodine for ablation of thyroid gland. After three months she became hypothyrotic. We had to continue therapy with L-thyroxine and amiodarone. She is now for six months without paroxysmal atrial fibrillation and her clinical and laboratory findings are innormal range. Conclusion: Because of possible side effect of amiodarone therapy, patients have to be under frequent survey of thyroid status. Appearance of atrial fibrillation, worsening of arrhythmia or loss of body weight are alarm signals for thyrotoxicosis.
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