Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T18:35:01.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Surgical management of amiodarone-induced thyrotoxicosis in a patient with Eisenmenger's syndrome: literature review and case report

Published online by Cambridge University Press:  02 December 2008

R Pratap ,
A Qayyum ,
N Ahmad  and
P Jani
R Pratap
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital, Cambridge, UK
A Qayyum*
Affiliation:
Department of Otolaryngology, Ipswich Hospital, Cambridge, UK
N Ahmad
Affiliation:
Department of Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
P Jani
Affiliation:
Department of Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
*
Address for correspondence: Mr Asad Qayyum, 16 Lavendon House, 8 Paveley Street, London NW8 8TJ, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We present a patient with a rare combination of amiodarone-induced thyrotoxicosis and Eisenmenger's syndrome.

Method:

Case report and review of the world literature regarding the morbidity and mortality of surgical management of amiodarone-induced thyrotoxicosis and the potential hazards of non-cardiac surgery in patients with Eisenmenger's syndrome.

Results:

Failure of maximal medical therapy necessitated surgical management to treat amiodarone-induced thyrotoxicosis which, in this particular patient, carried significant risks. Total thyroidectomy was performed leading to rapid resolution of thyrotoxicosis, and the patient made an uncomplicated recovery. We present this case because of its rarity and the potentially hazardous nature of surgical intervention in patients with Eisenmenger's syndrome. The pathogenesis of amiodarone-induced thyrotoxicosis and the differing approaches of medical and surgical management are discussed.

Conclusion:

Based on our findings, we propose that surgical management should be considered earlier in the treatment algorithm (or possibly as first-line therapy) for amiodarone-induced thyrotoxicosis.

Keywords

AmiodaroneThyrotoxicosisThyroid SurgeryEisenmenger's Syndrome
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 11 , November 2009 , pp. 1276 - 1279
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Martino, E, Bartalena, L, Bogazzi, F, Braverman, L. The effects of amiodarone on the thyroid. Endocr Rev 2001;22:240–54Google ScholarPubMed
2Figge, HL, Figge, J. The effects of amiodarone on thyroid hormone function: a review of the physiology and clinical manifestations. J Clin Pharmacol 1990;30:588–95CrossRefGoogle ScholarPubMed
3Cattaneo, F. Type II amiodarone-induced thyrotoxicosis and concomitant papillary cancer of the thyroid. Eur J Endocrinol 2000;143:823–4CrossRefGoogle ScholarPubMed
4Saad, A, Falciglia, M, Steward, DL, Nikiforov, YE. Amiodarone-induced thyrotoxicosis and thyroid cancer: clinical, immunohistochemical, and molecular genetic studies of a case and review of the literature. Arch Pathol Lab Med 2004;128:807–10CrossRefGoogle ScholarPubMed
5Thorne, SA, Barnes, I, Cullinan, P, Somerville, J. Amiodarone-associated thyroid dysfunction: risk factors in adults with congenital heart disease. Circulation 1999;100:149–54CrossRefGoogle ScholarPubMed
6Lyons, B, Motherway, C, Casey, W, Doherty, P. The anaesthetic management of the child with Eisenmenger's syndrome. Can J Anaesth 1995;42:904–9CrossRefGoogle ScholarPubMed
7Kraayenbrink, MA, Steven, CM. Anaesthesia for carotid body tumour resection in a patient with the Eisenmenger syndrome. A case report. Anaesthesia 1985;40:1194–7CrossRefGoogle Scholar
8Kopka, A, McMenemin, IM, Serpell, MG, Quasim, I. Anaesthesia for cholecystectomy in two non-parturients with Eisenmenger's syndrome. Acta Anaesthesiol Scand 2004;48:782–6CrossRefGoogle ScholarPubMed
9Hofland, J, Gultuna, I, Tenbrinck, R. Xenon anaesthesia for laparoscopic cholecystectomy in a patient with Eisenmenger's syndrome. Br J Anaesth 2001;86:882–6CrossRefGoogle Scholar
10Temelcos, C, Kuhn, R, Stribley, C. Sterilization of women with Eisenmenger syndrome: report of 4 cases. Aust N Z J Obstet Gynaecol 1997;37:121–3CrossRefGoogle ScholarPubMed
11Houghton, SG, Farley, DR, Brennan, MD, van Heerden, JA, Thompson, GB, Grant, CS. Surgical management of amiodarone-associated thyrotoxicosis: Mayo Clinic experience. World J Surg 2004;28:1083–7CrossRefGoogle ScholarPubMed
12Hamoir, E, Meurisse, M, Defechereux, T, Joris, J, Vivario, J, Hennen, G. Surgical management of amiodarone-associated thyrotoxicosis: too risky or too effective? World J Surg 1998;22:537–42, 542–3CrossRefGoogle ScholarPubMed
13Mulligan, DC, McHenry, CR, Kinney, W, Esselstyn, CB. Amiodarone-induced thyrotoxicosis: clinical presentation and expanded indications for thyroidectomy. Surgery 1993;114:1114–19Google ScholarPubMed
14Claxton, S, Sinha, SN, Donovan, S, Greenway, TM, Hoffman, L, Loughead, M et al. Refractory amiodarone-associated thyrotoxicosis: an indication for thyroidectomy. Aust N Z J Surg 2000;70:174–8CrossRefGoogle ScholarPubMed
15Brennan, MD, van Heerden, JA, Carney, JA. Amiodarone-associated thyrotoxicosis (AAT): experience with surgical management. Surgery 1987;102:1062–7Google ScholarPubMed
16Bogazzi, F, Miccoli, P, Berti, P, Cosci, P, Brogioni, S, Aghini-Lombardi, F et al. Preparation with iopanoic acid rapidly controls thyrotoxicosis in patients with amiodarone-induced thyrotoxicosis before thyroidectomy. Surgery 2002;132:1114–17CrossRefGoogle ScholarPubMed
17Meurisse, M, Detroz, B, Messens, D, D'Silva, M, Zakaria, Z, Joris, J et al. The treatment of amiodarone-induced hyperthyroidism. Is there a place for surgery? Acta Chir Belg 1994;94:36–41Google Scholar
18Meurisse, M, Hamoir, E, D'Silva, M, Joris, J, Hennen, G. Amiodarone-induced thyrotoxicosis: is there a place for surgery? World J Surg 1993;17:622–6CrossRefGoogle Scholar
19Painvin, I, Dupuis, JM, Victor, J, Rohmer, V, Ronceray, J, Tadei, A. Value of thyroidectomy in amiodarone-induced hyperthyroidism. Arch Mal Coeur Vaiss 1996;89:445–9Google ScholarPubMed
20Gough, IR, Gough, J. Surgical management of amiodarone-associated thyrotoxicosis. Med J Aust 2002;176:128–9CrossRefGoogle ScholarPubMed
21Franzese, CB, Fan, CY, Stack, BC. Surgical management of amiodarone-induced thyrotoxicosis. Otolaryngol Head Neck Surg 2003;129:565–70Google ScholarPubMed
22Chiovato, L, Martino, E, Tonacchera, M, Santini, F, Lapi, P, Mammoli, C et al. Studies on the in vitro cytotoxic effect of amiodarone. Endocrinology 1994;134:2277–82CrossRefGoogle ScholarPubMed
23Newman, CM, Price, A, Davies, DW, Gray, TA, Weetman, AP. Amiodarone and the thyroid: a practical guide to the management of thyroid dysfunction induced by amiodarone therapy. Heart 1998;79:121–7CrossRefGoogle Scholar
24Osman, F, Franklyn, JA, Sheppard, MC, Gammage, MD. Successful treatment of amiodarone-induced thyrotoxicosis. Circulation 2002;105(11):1275–7CrossRefGoogle ScholarPubMed
25Loh, KC. Amiodarone-induced thyroid disorders: a clinical review. Postgrad Med J 2000;76:133–40CrossRefGoogle ScholarPubMed
26Roffi, M, Cattaneo, F, Brandle, M. Thyrotoxicosis and the cardiovascular system. Minerva Endocrinol 2005;30:47–58Google ScholarPubMed
27Sutherland, J, Robinson, B, Delbridge, L. Anaesthesia for amiodarone-induced thyrotoxicosis: a case review. Anaesth Intensive Care 2001;29:24–9CrossRefGoogle ScholarPubMed
28Foster, JM, Jones, RM. The anaesthetic management of the Eisenmenger syndrome. Ann R Coll Surg Engl 1984;66:353–5Google ScholarPubMed