Mild and short recurrence of type II amiodarone-induced thyrotoxicosis in three patients receiving amiodarone continuously for more than 10 years
Mild and short recurrence of type II amiodarone-induced thyrotoxicosis in three patients receiving amiodarone continuously for more than 10 years
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DOI：
10.1507/endocrj.k06-027
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发表时间：
2006-08-01
影响因子：
2
通讯作者：
Kasanuki, Hiroshi
中科院分区：
文献类型：
--
作者：
Sato, Kanji;Shiga, Tsuyoshi;Kasanuki, Hiroshi
虽然有两种类型的胺碘酮诱导的甲状腺毒症（AIT），只有II型AIT已在我们的机构在日本到目前为止。AIT复发的病例报告很少，可能是因为一旦发生AIT，胺碘酮立即停用。我们自己的政策是不停止胺碘酮在所有AFT患者，除非严重的不良反应，如肺纤维化的发展。在我们遇到的50多例II型AIT患者中，3例致心律失常性右心室心肌病患者显示AIT复发。在这些患者中，AIT的首次发作发生在胺碘酮给药开始后3年、4年和2年，并分别在首次发作后5年、6年和8年观察到复发。所有病例的AIT均自行消退，而患者继续服用胺碘酮。与第一次AIT发作相比，第二次AIT发作较轻，并在较短时间内消退。这三例病例表明，II型AIT的复发在碘充足的地区可能并不罕见，而且相对较轻，可能会自发消退。此外，至少在日本，复发性II型AIT患者可能继续服用胺碘酮。
Although there are two types of amiodarone-induced thyrotoxicosis (AIT), only type II AIT has been seen at our institution in Japan so far. There have been few case reports of AIT recurrence, probably because of the fact that amiodarone is immediately discontinued once AIT has developed. Our own policy is not to discontinue amiodarone in all AFT patients, unless severe adverse effects such as pulmonary fibrosis develop. Among more than 50 patients with type II AIT we have encountered, three with arrhythmogenic right ventricular cardiomyopathy showed AIT recurrence. In these patients, the first episode of AIT developed 3, 4, and 2 years after the start of amiodarone administration, and recurrence was observed 5, 6, and 8 years after the first episode, respectively. The AIT resolved spontaneously in all cases while the patients continued to take amiodarone. In comparison with the first AIT episode, the second was milder and resolved within a shorter period. These three cases suggest that recurrence of type II AIT may not be rare in iodine-sufficient areas, and that it is relatively mild and may resolve spontaneously. Furthermore, at least in Japan, it may be possible for patients with recurrent type II AIT to continue taking amiodarone.