| Amiodarone is an iodine-rich benzofuran derivative widely used in the treatment of various clinical tachyarrhythmias,such as supraventricular tachycardia,ventricular tachycardia,atrial fibrillation and so on,owing to its broad-spectrum antiarrhythmic effect.However,due to its unique biological characteristics such as high iodine content and long biological half-life,thyroid dysfunction may occur during a period of time after receiving long-term treatment or even stopping amiodarone.Amiodarone-induced hypothyroidism(AIH)and Amiodarone-induced thyrotoxicosis(AIT)are common side effects.The most likely pathogenesis of amiodarone-induced hypothyroidism(AIH)is due to the loss of Wolff-Chaikoff effect after iodine load in the body,which inhibits the synthesis and release of thyroid hormone and prevents the recovery of normal thyroid hormone synthesis.The diagnosis and method of treatment are the same as the common case of hypothyroidism.Amiodarone-induced hyperthyroidism(AIT)is divided into two subtypes:type 1 AIT and type 2 AIT,sometimes with a mixed type of both.The pathogenesis of type 1 AIT is mainly due to excessive thyroid hormone synthesis induced by excessive iodine and its metabolites;type 2 AIT is mainly caused by amiodarone-related destructive thyroiditis.Because the pathogenesis of the two AIT is different,the treatment plan is completely different,thus the differential diagnosis and treatment of the two subtypes of AIT are crucial and challenging.In this article,With the aid of a case analysis elaborating a typical type 2 AIT,and through consulting a large number of literatures,we systematically review the mechanism,diagnosis,differential diagnosis and therapeutic aspects of amiodarone-induced thyroid dysfunction.It aims to improve the level of diagnosis and treatment of AIT in clinicians. |
PDF Full Text Request