Pérez Parras M A, Marín Patón M, Negrillo Cantero A M, Caro Cruz E, González Rivera F, Moreno Carazo A
Servicio de Pediatría. Hospital General de Especialidades Ciudad de Jaén.
An Esp Pediatr. 2000 Oct;53(4):377-9.
Amiodarone is extensively used in cardiology practice because of its excellent antiarrhythmic properties. It produces alterations in thyroid functional because it contains 37% iodine and it is structurally similar to the thyroid hormones. Amiodarone inhibits 5'-deiodinase in the liver. The incidence of amiodarone-induced hyperthyroidism is between 6% and 12% of treated patients. The figures for pediatric patients are similar. Determination of tri-iodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) plays an important role in the diagnosis and follow-up of thyroid alterations. Treatment options in amiodarone-induced hyperthyroidism in children include thionamide, potassium perchlorate, and prednisone. We present the case of hyperthyroidism secondary to amiodarone in a 10-year-old boy with Marfan's syndrome who was admitted several times for crises of paroxysmal supraventricular tachycardia and atrial fibrillation. After amiodarone treatment he presented a clinical and analytical picture of hyperthyroidism with very low TSH levels and increased free-T4 levels. Thyroid echography and scintigraphy were normal. Treatment with thiamazole did not alter the clinical picture, which returned to normal after prednisone administration. Currently, prednisone is being slowly withdrawn.Amiodarone. Hyperthyroidism. Antiarrhythmics.
胺碘酮因其出色的抗心律失常特性而在心脏病学实践中被广泛应用。它会引起甲状腺功能改变，因为其含有37%的碘且在结构上与甲状腺激素相似。胺碘酮抑制肝脏中的5'-脱碘酶。胺碘酮所致甲状腺功能亢进的发生率在接受治疗患者中的比例为6%至12%。儿科患者的情况类似。三碘甲状腺原氨酸（T3）、甲状腺素（T4）和促甲状腺激素（TSH）的测定在甲状腺改变的诊断和随访中起着重要作用。儿童胺碘酮所致甲状腺功能亢进的治疗选择包括硫酰胺、高氯酸钾和泼尼松。我们报告一例10岁患有马方综合征的男孩因阵发性室上性心动过速和心房颤动发作多次入院，在接受胺碘酮治疗后出现胺碘酮所致甲状腺功能亢进的临床和分析表现，TSH水平极低，游离T4水平升高。甲状腺超声和闪烁扫描均正常。甲巯咪唑治疗未改变临床表现，泼尼松给药后恢复正常。目前，泼尼松正在缓慢减量。胺碘酮。甲状腺功能亢进。抗心律失常药。
