2021, Number 4
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Med Int Mex 2021; 37 (4)
Amiodarone-induced hypothyroidism in a patient with arrhythmogenic cardiomyopathy
Salcido-Carmona CA, López-Quijano JM, Vidal-Morales G, Reyes-Mitre A, Reyes-Guzmán MÁ, Galicia-Martínez MÁ
Language: Spanish
References: 12
Page: 627-632
PDF size: 191.30 Kb.
ABSTRACT
Background: The initial indication of amiodarone was as an antianginal. Subsequently,
the FDA authorized it as an antiarrhythmic in malignant ventricular tachycardias.
Clinical case: A 61-year-old male patient with a history of arrhythmogenic
right ventricular cardiomyopathy, diagnosed in 2006 and initially treated with
amiodarone 200 mg/day. In 2019 patient went to the emergency department due
to paraesthesia in the upper extremities and thorax. During his study protocol,
pericardial effusion and ascites were detected, with suspected chronic hypothyroidism,
peripheral neuropathy and congestive heart failure. Thyroid function tests
reported thyrotropin of 72 µU/mL and total thyroxine of 2.08 µg/dL. Substitution
began with 50 µ/day of levothyroxine and management of decompensated heart
failure, with clinical improvement.
Conclusions: Chronic use of amiodarone can cause various organic disorders,
one of the most common (15%) is the thyroid, so we must keep a close eye on the
patient. Positive antithyroid antibodies can predict drug-induced hypothyroidism and
alert us to follow-up.
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