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一名心脏病患者难治性胺碘酮所致甲状腺毒症的确定性手术治疗:病例报告

Definitive Surgical Management of Refractory Amiodarone-Induced Thyrotoxicosis in a Cardiac Patient: A Case Report.

作者信息

Shah Islam, Fabricante Jonathan, Vattiyam Veettil Fahas Ali

机构信息

Internal Medicine (General Medicine), District Headquarter Hospital, Daggar, PAK.

Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK.

出版信息

Cureus. 2025 May 2;17(5):e83354. doi: 10.7759/cureus.83354. eCollection 2025 May.

Abstract

Amiodarone-induced thyrotoxicosis (AIT) presents a significant therapeutic challenge, particularly in patients with underlying cardiac comorbidities. We present a 58-year-old man with a background history of ischemic heart disease and atrial fibrillation who developed AIT following long-term amiodarone use. Despite the escalation of medical therapy, he remained clinically and biochemically thyrotoxic with symptomatic atrial fibrillation. Definitive management via total thyroidectomy was performed, resulting in clinical stabilization. This case highlights the importance of early multidisciplinary input and the role of total thyroidectomy in managing refractory AIT in high-risk cardiac patients.

摘要

胺碘酮所致甲状腺毒症(AIT)带来了重大的治疗挑战,尤其是在有潜在心脏合并症的患者中。我们报告一名58岁男性,有缺血性心脏病和心房颤动病史,长期使用胺碘酮后发生了AIT。尽管加强了药物治疗,但他在临床和生化指标上仍处于甲状腺毒症状态,并伴有症状性心房颤动。通过甲状腺全切除术进行了确定性治疗,使病情临床稳定。该病例凸显了早期多学科协作的重要性以及甲状腺全切除术在管理高危心脏患者难治性AIT中的作用。

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