Amiodarone-induced thyrotoxicosis in a pediatric patient: A rare and demanding clinical case.

Sofia Oliveira,Lurdes Lopes,Bernardo Marques,Sérgio Laranjo

doi:10.4081/pr.2019.8166

Abstract

Thyroid dysfunction is one of the most common adverse effects of amiodarone therapy, ranging from subclinical changes to overt clinical thyrotoxicosis (AIT) and/or hypothyroidism. Due to its heterogeneity, AIT lasts as a defiant entity, leading to a thorny treatment course, particularly in pediatrics. AIT can be classified as either type 1, type 2 or mixed form based on its pathophysiology. Differentiating between the main AIT subtypes is quite relevant, since there is specific treatment for both, however, this distinction may be difficult in clinical practice. We describe a rare case of AIT in a pediatric patient, with an uncommon congenital cardiac malformation, that started amiodarone therapy due to paroxysmal supraventricular tachycardia. AIT was reported 26 months after drug onset, with a sudden and explosive emerging. This case highlights the current AIT management challenges on the highdemanding pediatric field pursuing, ultimately, an enhanced patient´s care.

Highlights

Universitário de São João, Porto; variable half-life, from 50 to 100 days.[2]
Porto; 5Department of Endocrinology, Instituto Português de Oncologia de the most common side effects of amiodarone therapy, Acknowledgments: thanks are due to Associação dos Amigos do Serviço de Endocrinologia do Coimbra Francisco Gentil, Coimbra; 6Department of Pediatric Cardiology, ly Centro Hospitalar de Lisboa Central, Lisbon, Portugal e on Abstract us Thyroid dysfunction is one of the most l common adverse effects of amiodarone ia therapy, ranging from subclinical changes to overt clinical thyrotoxicosis (AIT) and/or c hypothyroidism
We describe a rare case of n AIT in a pediatric patient, with an o uncommon congenital cardiac malformation, that started amiodarone therapy due to

Summary

Case Report

We describe a rare case of AIT in a pediatric patient, with an uncommon moderate-to-severe tricuspid insufficiency, starting thiamazole the patient had gained congenital cardiac malformation, that had who underwent several corrective surgical 5kg, presenting sustained clinical and started amiodarone therapy due to interventions (the last one in 2014), started analytical enhance. The accurate underlying mechanism of 2015 due to paroxysmal supraventricular treatment was completely discontinued 1.5 amiodarone effects on thyroid function is tachycardia. He was referred to Pediatric months later. To be fully unveiled.[1,2,3,4,5] Given the small dysfunction compatible with thyrotoxicosis; number of pediatric patients and the lack of he had no personal or family history of controlled studies, only scarce data can be thyroid disease and prior thyroid tests proved found in the literature regarding the to be normal

Discussion pathophysiology particularities and outcome

Findings

The distinction between the two main

Conclusions