Mazonson P D, Williams M L, Cantley L K, Dalldorf F G, Utiger R D, Foster J R
Am J Med. 1984 Oct;77(4):751-4. doi: 10.1016/0002-9343(84)90379-6.
Amiodarone is a potent new antiarrhythmic drug that has multiple effects on thyroid function, including inhibition of extrathyroidal triiodothyronine production and rarely, iodine-induced hypothyroidism. This report describes a man with recurrent ventricular tachycardia in whom hypothyroidism developed during amiodarone therapy and who died of probable myxedema coma. Parenteral and oral thyroxine therapy promptly reduced serum thyroid-stimulating hormone concentrations without increasing the patient's very low serum triiodothyronine concentration. This response to thyroxine suggests that thyroxine itself may have biologic activity and participate directly in regulation of thyrotropin secretion. Because amiodarone-induced hypothyroidism may be life-threatening, thyroid function should be monitored before and during amiodarone therapy, and the drug discontinued or appropriate therapy instituted if hypothyroidism develops.
胺碘酮是一种强效的新型抗心律失常药物，对甲状腺功能有多种影响，包括抑制甲状腺外三碘甲状腺原氨酸的产生，以及罕见的碘致甲状腺功能减退。本报告描述了一名患有复发性室性心动过速的男性，他在胺碘酮治疗期间出现甲状腺功能减退，并死于可能的黏液性水肿昏迷。胃肠外和口服甲状腺素治疗迅速降低了血清促甲状腺激素浓度，而未提高患者极低的血清三碘甲状腺原氨酸浓度。这种对甲状腺素的反应表明，甲状腺素本身可能具有生物活性，并直接参与促甲状腺素分泌的调节。由于胺碘酮所致甲状腺功能减退可能危及生命，因此在胺碘酮治疗前和治疗期间应监测甲状腺功能，如果发生甲状腺功能减退，应停用该药物或采取适当治疗措施。
