• Clin Med (Lond) · Sep 2021

    Case Reports

    Resistant type 2 amiodarone-induced thyrotoxicosis responsive to cholestyramine as an adjunctive therapy.

    • Aisha Rummaan, Maryam Maryam, Awais Ali, Snigdhendu Mandal, and Tamar Saeed.
    • The Dudley Group NHS Foundation Trust, Dudley, UK.
    • Clin Med (Lond). 2021 Sep 1; 21 (5): e529e530e529-e530.

    AbstractAmiodarone is a class 3 antiarrhythmic drug which may be associated with thyroid dysfunction. Amiodarone-induced thyrotoxicosis (AIT) is classified as type 1 (AIT 1; which may develop in the presence of latent autoimmune hyperthyroid condition) or type 2 (AIT 2; which develops in an apparently normal thyroid resulting from destructive thyroiditis). AIT 1 routinely requires treatment with thionamides, whereas AIT 2 is treated with steroids. Resistance to the conventional treatment of hyperthyroidism is not commonly found in clinical practice. This report discusses a case of AIT 2 resistant to conventional treatment. Despite being on high doses of carbimazole and steroids (prednisolone), the patient remained thyrotoxic. Cholestyramine, a bile salt sequestrant, was used as an adjunctive therapy resulting in significant clinical and biochemical improvement. The patient subsequently became euthyroid and is being followed up in endocrine clinic.© Royal College of Physicians 2021. All rights reserved.

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