Endocrine Abstracts (2010) 22 P765

Amiodarone-induced thyrotoxicosis in patients with multinodular goiter: type 1 or type 2 AIT?

Luca Tomisti, Enrica Dell’Unto, Sandra Brogioni, Chiara Cosci, Enio Martino & Fausto Bogazzi


Department of Endocrinology, University of Pisa, Pisa, Italy.


Introduction: Type 2 amiodarone-induced thyrotoxicosis (AIT) is a form of destructive thyroiditis, commonly responsive to glucocorticoids. On the contrary, type 1 AIT is an iodine-induced hyperthyroidism, occurring in patients with underlying thyroid disease often responding to thionamides.

Aim of the study: To compare the effectiveness of methimazole (MMI) or prednisone (GLU) in the treatment of AIT patients with multinodular goiter with biochemical features of destructive thyroditis.

Patients and methods: We enrolled 22 untreated AIT patients with multinodular goiter in a historical prospective study. The patients showed similar biochemical findings; particularly all patients showed low thyroidal radioactive iodine uptake (24th h RAIU <5%) and an estimated thyroid volume with conventional ultrasonography >25 ml. Eleven patients were treated with metimazole (initial dose 40 mg/day) (MMI GROUP) and 11 patients were treated with prednisone (initial dose, 0.5 mg/kg per day) (GLU GROUP) for 4 months (120 days).

Results: After 120 days euthyroidism was restored in 9/11 patients treated with glucocorticoids (81.8%) and in 4/11 patients treated with MMI (36.3%) (P 0.03). Furthermore, patients in GLU GROUP reached euthyroidism more rapidly than those in MMI Group (median cure time GLU GROUP 33 days versus median cure time MMI GROUP >120 days, P=0.01).

Conclusion: This data suggest that AIT patients with multinodulare goiter but biochemical features of destructive thyroiditis could respond more favorable to glucocorticoids therapy than to thionamides therapy.

Article tools

My recent searches

No recent searches.