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  • Title: [Usefulness of thyroid scintigraphy in the therapeutic management of amiodarone-induced hyperthyroidism].
    Author: Pacheco Capote C, Mena Bares LM, Benítez Velazco A, Louhibi Rubio L, Contreras Puertas PI, Maza Muret FR, Latre Romero JM.
    Journal: Rev Esp Med Nucl; 2007; 26(5):270-6. PubMed ID: 17910835.
    Abstract:
    UNLABELLED: Amiodarone-induced hyperthyroidism is relatively common in iodine-deficient regions. Two types have been described: type I, caused by increased synthesis and release of thyroid hormone in individuals with underlying thyroid disease, can be treated with antithyroid drugs or radioiodine; and type II, a destructive thyroiditis responsive to corticoid therapy but not to antithyroid drugs. It can be difficult to distinguish between the two types, and cases of mixed types have been reported. OBJECTIVE: to assess the usefulness of thyroid scintigraphy in amiodarone-induced hyperthyroidism. MATERIALS AND METHODS: 27 consecutive patients (13 females) with amiodarone-induced hyperthyroidism. Mean age was 65 years (range: 39-89). All patients underwent 99mTc-pertechnectate thyroid scintigraphy and were classified according to the qualitative estimation of radiotracer uptake: type I (increased / normal uptake): 9 patients, all of whom responded to antithyroid drugs or radioiodine, except one patient with sub-clinical hyperthyroidism who received no therapy; type II (very low or undetectable uptake): 13 patients, 11 of whom responded to discontinuation of amiodarone or prednisone therapy (2 patients). Hyperthyroidism was resistant in 2 patients and required antithyroid drugs or potassium perchlorate; mixed type (low uptake but with underlying thyroid pathology): 5 patients, with variable evolution; all needed antithyroid drugs, one required subtotal thyroidectomy, and another radioiodine treatment. CONCLUSION: thyroid scintigraphy can establish the correct therapeutic approach in most cases of amiodarone-induced hyperthyroidism, making it essential in the clinical management of these patients.
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