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Titolo:
The various effects of amiodarone on thyroid function
Autore:
Bogazzi, F; Bartalena, L; Gasperi, M; Braverman, LE; Martino, E;
Indirizzi:
Univ Pisa, Dipartimento Endocrinol & Metab, Pisa, Italy Univ Pisa Pisa Italy Pisa, Dipartimento Endocrinol & Metab, Pisa, Italy Univ Insubria, Cattedra Endocrinol, Varese, Italy Univ Insubria Varese Italy Insubria, Cattedra Endocrinol, Varese, Italy Boston Univ, Med Ctr, Sect Endocrinol Diabet & Nutr, Boston, MA USA BostonUniv Boston MA USA Sect Endocrinol Diabet & Nutr, Boston, MA USA
Titolo Testata:
THYROID
fascicolo: 5, volume: 11, anno: 2001,
pagine: 511 - 519
SICI:
1050-7256(200105)11:5<511:TVEOAO>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
IODINE-INDUCED THYROTOXICOSIS; RECEPTOR MESSENGER-RNA; INDUCED HYPOTHYROIDISM; ANTITHYROID ANTIBODIES; POTASSIUM PERCHLORATE; SERUM INTERLEUKIN-6; LITHIUM-THERAPY; HORMONE ACTION; FOLLOW-UP; IN-VITRO;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
77
Recensione:
Indirizzi per estratti:
Indirizzo: Martino, E Univ Pisa, Osped Cisanello, Dipartimento Endocrinol & Metab, Via Paradisa 2, I-56124 Pisa, Italy Univ Pisa Via Paradisa 2 Pisa Italy I-56124 -56124 Pisa, Italy
Citazione:
F. Bogazzi et al., "The various effects of amiodarone on thyroid function", THYROID, 11(5), 2001, pp. 511-519

Abstract

Amiodarone, a benzofuranic-derivative iodine-rich drug used mostly for tachyarrhythmias, often causes changes in the peripheral metabolism of thyroidhormones mainly due to the inhibition of 5'-deiodinase activity: an increase in serum thyroxine and reverse triiodothyronine, and a decrease in serumtriiodothyronine concentrations. Overt thyroid dysfunction, either amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH), occurring in 14% to 18% of patients receiving long-term treatment, may develop both in apparently normal thyroid glands and in glands with preexisting abnormalities. AIH is mainly due to the failure to escape from the acuteWolff-Chaikoff effect, and, in patients with thyroid autoimmune phenomena,to concomitant Hashimoto's thyroiditis. AIT is due to excess iodine-induced thyroid hormone synthesis (type I AIT) or to amiodarone-related destructive thyroiditis (type II AIT), although mixed forms often occur. Treatment of AIH consists of levothyroxine replacement therapy while continuing amiodarone therapy; alternatively, amiodarone can be discontinued, if possible, and the natural course toward euthyroidism can be accelerated by a short trial of potassium perchlorate. In type I AIT, the simultaneous administrationof thionamides and potassium perchlorate is the treatment of choice, whilein type II AIT steroids are the most useful therapeutic option. Mixed forms are best treated with a combination of thionamides, potassium perchlorate, and glucocorticoids. The low thyroidal I-131 uptake usually makes radioiodine therapy not feasible, while thyroidectomy is a valid alternative in cases resistant to medical therapy.

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Documento generato il 25/01/20 alle ore 03:25:05