Rıdvan Sivritepe, Sema Uçak Basat, Ece Yiğit, Hanife Şerife Aktaş

Amiodaron Kullanımına Bağlı Gelişen Hipotiroidi Tablosu

Günümüzde ventriküler aritmi, paroksismal supraventriküler taşikardi, atriyal fibrilasyon, atriyal flutter gibi aritmilerin tedavisinde sıklıkla kullanılan bir antiaritmik olan amiodoronun en sık ve en önemli yan etkilerinden biri tiroid disfonksiyonuna sebep olmasıdır. Hastaların büyük çoğunluğu ötiroid kalmakla birlikte bazılarında tirotoksikoz bazılarında ise hipotiroidi tablosu ortaya çıkmaktadır. Amiodorona bağlı tirotoksikoz insidansı %1-23 arasında, hipotiroidi insidansı ise %1-32 arasında değişmektedir. Vakamızda amiodoron kullanımına bağlı hipotiroidi gelişen bir hastayı sunduk.

Anahtar Kelimeler:

Amiodaron, Tiroid Disfonksiyonu, Hipotiroidi

Hypothyroidism Secondary To Amiodarone Use

In recent years amiodarone is used in the treatment of arrhythmias such as atrial flutter, ventricular arrhythmia, paroxysmal supraventricular tachycardia, atrial fibrillation. The most common and important side effect of amiodarone is to cause thyroid dysfunction. Although the majority of patients are euthyroid, thyrotoxicosis or hypothyroidism occurs in some patients. Amiodarone induced thyrotoxicosis incidence of between 1-23%, and the incidence of hypothyroidism varies between 1-32%. In our case we present a patient with hypothyroidism secondary to amiodarone use.

Keywords:

Amiodarone, Thyroid Dysfunction, Hypothyroidism,

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Salemo DM, Gillingham KJ, Berry DA, Hodges M A comparison of antiarrhythmic drugs for the suppression of ventricular ectopic depolarisations: A meta-analysis. Am Heart J 120,340-353 ( 1990)
Basaria, S., & Cooper, D. S. (2005). Amiodarone and the thyroid. The American journal of medicine, 118(7), 706-714.
Smyrk, T. C., Goellner, J. R., Brennan, M. D., & Carney, J. A. (1987). Pathology of the thyroid in amiodarone-associated thyrotoxicosis. The American journal of surgical pathology, 11(3), 197-204
Broekhuysen, J.; Laruel, R. and Sion, R.: Recherches dans Ia série des benzofurannes. XXXVII. Étude comparée du transit et du métabolisme de l’amiodarone chez diverses espèces animales et chez l’homme. Archives Internationales de Pharmacodynamie et de Therapie 177: 340–359 (1969)
Ünal, N., & Gürlek, A. (2005). Amiodaron ve tiroid. Hacettepe Tıp Dergisi, 36, 152-156.
Haffajee CI, Love JC, Canada AT, Lesko LJ, Asdourian G, Alpert JS: Clinical pharmacokinetics and efficacy of amiodarone for refractory tachyarrhythmias. Circularion 67,1347-1 355 ( 1983)
Rotmensch HH, Belhassen B, Swanson BN, Shoshani D, Spielman SR, Greenspon kl, Greenspan AM, Vlasses PH, Horowitz LN: Steady-state serum amiodarone concentrations: Relationships with antiarrhythmic efficacy and toxicity. Ann Intern Med 101,462469 (1984)
Iudica-Souza C, Burch HB 1999 Amiodarone-induced thyroid dysfunction. The Endocrinologist 9:216–227.
Loh, K. C. (2000). Amiodarone-induced thyroid disorders: a clinical review. Postgraduate medical journal, 76(893), 133-140.
Amiodaron Trials Meta-Analysis Investigators: Effect of prophylactic amiodarone on mortality after acute myocardial infarction and in congestive heart failure: metaanalysis of individual data from 6500 patients in randomised trials. Lancet 1997;350:1417-1424.)
Hohnloser SH, Singh BN. Proarrhythmia with class III antiarrhythmic drugs: definition, electrophysiological mechanisms, incidence, predisposing factors, and clinical implications. J Cardiovasc Electrophysiol 1995;6:920-936.
Holt DW Tucker GT, Jackson PR, Storey GCA. Amiodarone pharmacokineticks. AM Heart J 1983;106:843-847.
http://www.acilci.net/amiodaron
Gopalan, M. (2009). Thyroid dysfunction induced by amiodarone therapy. Updated: Jul, 2.
ERSOY, C. Ö. (2014). Hipotiroidizm tedavisi. Turkiye Klinikleri Journal of Endocrinology Special Topics, 7(3), 37-40.
Martino E, Mariotto S, Aghini-Lombardi F, et al. Short term administration of potasyum perchlorate restores euthyroidism in amiodarone iodine induced hypothyroidism. J Clin Endocrinol Metab 1986; 63:1233-6

ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez