A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report

<p>Abstract</p> <p>Background</p> <p>Amiodarone is a widely used antiarrythmic drug, which may produce secondary effects on the thyroid. In 14–18% of amiodarone-treated patients, there is overt thyroid dysfunction, usually in the form of amiodarone-induced thyrotoxicosi...

Full description

Bibliographic Details
Main Authors: Papaioannou Vasilios, Terzi Irene, Dragoumanis Christos, Konstantonis Dimitrios, Theodorou Vassiliki, Pneumatikos Ioannis
Format: Article
Language:English
Published: BMC 2007-11-01
Series:Journal of Medical Case Reports
Online Access:http://www.jmedicalcasereports.com/content/1/1/134
_version_ 1818556005175263232
author Papaioannou Vasilios
Terzi Irene
Dragoumanis Christos
Konstantonis Dimitrios
Theodorou Vassiliki
Pneumatikos Ioannis
author_facet Papaioannou Vasilios
Terzi Irene
Dragoumanis Christos
Konstantonis Dimitrios
Theodorou Vassiliki
Pneumatikos Ioannis
author_sort Papaioannou Vasilios
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Amiodarone is a widely used antiarrythmic drug, which may produce secondary effects on the thyroid. In 14–18% of amiodarone-treated patients, there is overt thyroid dysfunction, usually in the form of amiodarone-induced thyrotoxicosis, which can be difficult to manage with standard medical treatment.</p> <p>Case presentation</p> <p>Presented is the case of a 65-year-old man, under chronic treatment of atrial fibrillation with amiodarone, who was admitted to the Intensive Care Unit with acute cardio-respiratory failure and fever. He was recently hospitalized with respiratory distress, attributed to amiodarone-induced pulmonary fibrosis. Clinical and laboratory investigation revealed thyrotoxicosis due to amiodarone treatment. He was begun on thionamide, prednisone and beta-blockers. After a short term improvement of his clinical status the patient underwent percutaneous tracheotomy due to weaning failure from mechanical ventilation, which led to the development of recurrent thyrotoxicosis, unresponsive to medical treatment. Finally, the patient developed multiple organ failure and died, seven days later.</p> <p>Conclusion</p> <p>We suggest that percutaneous tracheotomy could precipitate a thyrotoxic crisis, particularly in non-euthyroid patients suffering from concurrent severe illness and should be performed only in parallel with emergency thyroid surgery, when indicated.</p>
first_indexed 2024-12-13T23:41:52Z
format Article
id doaj.art-6c6b098cae8440a3b5156a93bdc36b26
institution Directory Open Access Journal
issn 1752-1947
language English
last_indexed 2024-12-13T23:41:52Z
publishDate 2007-11-01
publisher BMC
record_format Article
series Journal of Medical Case Reports
spelling doaj.art-6c6b098cae8440a3b5156a93bdc36b262022-12-21T23:27:08ZengBMCJournal of Medical Case Reports1752-19472007-11-011113410.1186/1752-1947-1-134A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case reportPapaioannou VasiliosTerzi IreneDragoumanis ChristosKonstantonis DimitriosTheodorou VassilikiPneumatikos Ioannis<p>Abstract</p> <p>Background</p> <p>Amiodarone is a widely used antiarrythmic drug, which may produce secondary effects on the thyroid. In 14–18% of amiodarone-treated patients, there is overt thyroid dysfunction, usually in the form of amiodarone-induced thyrotoxicosis, which can be difficult to manage with standard medical treatment.</p> <p>Case presentation</p> <p>Presented is the case of a 65-year-old man, under chronic treatment of atrial fibrillation with amiodarone, who was admitted to the Intensive Care Unit with acute cardio-respiratory failure and fever. He was recently hospitalized with respiratory distress, attributed to amiodarone-induced pulmonary fibrosis. Clinical and laboratory investigation revealed thyrotoxicosis due to amiodarone treatment. He was begun on thionamide, prednisone and beta-blockers. After a short term improvement of his clinical status the patient underwent percutaneous tracheotomy due to weaning failure from mechanical ventilation, which led to the development of recurrent thyrotoxicosis, unresponsive to medical treatment. Finally, the patient developed multiple organ failure and died, seven days later.</p> <p>Conclusion</p> <p>We suggest that percutaneous tracheotomy could precipitate a thyrotoxic crisis, particularly in non-euthyroid patients suffering from concurrent severe illness and should be performed only in parallel with emergency thyroid surgery, when indicated.</p>http://www.jmedicalcasereports.com/content/1/1/134
spellingShingle Papaioannou Vasilios
Terzi Irene
Dragoumanis Christos
Konstantonis Dimitrios
Theodorou Vassiliki
Pneumatikos Ioannis
A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report
Journal of Medical Case Reports
title A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report
title_full A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report
title_fullStr A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report
title_full_unstemmed A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report
title_short A fatal case of recurrent amiodarone-induced thyrotoxicosis after percutaneous tracheotomy: a case report
title_sort fatal case of recurrent amiodarone induced thyrotoxicosis after percutaneous tracheotomy a case report
url http://www.jmedicalcasereports.com/content/1/1/134
work_keys_str_mv AT papaioannouvasilios afatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT terziirene afatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT dragoumanischristos afatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT konstantonisdimitrios afatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT theodorouvassiliki afatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT pneumatikosioannis afatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT papaioannouvasilios fatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT terziirene fatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT dragoumanischristos fatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT konstantonisdimitrios fatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT theodorouvassiliki fatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport
AT pneumatikosioannis fatalcaseofrecurrentamiodaroneinducedthyrotoxicosisafterpercutaneoustracheotomyacasereport