What are the ETA treatment guidelines for amiodarone-associated thyroid dysfunction?

Updated: Aug 28, 2020
  • Author: Mini Gopalan, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

In 2018, the European Thyroid Association published guidelines concerning amiodarone-related thyroid dysfunction management. Recommendations include the following [16] :

  • Patients with amiodarone-induced thyrotoxicosis (AIT) should be considered at risk of an emergency treatment at any time due to the increased mortality and morbidity, particularly in the elderly and/or if a reduced left ventricular dysfunction is present
  • Antithyroid drugs are recommended as the medical treatment of choice for most cases of AIT 1
  • Oral glucocorticoids are recommended as the first-line treatment for AIT 2 with moderate to severe thyrotoxicosis; the decision to treat milder or subclinical forms should take into account the underlying cardiac conditions, with a close interaction with the specialist cardiologist
  • Ablation of a hyperfunctioning thyroid gland with an elective thyroidectomy or radioiodine treatment, as in other forms of spontaneous hyperthyroidism, is recommended

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