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Amiodarone induced hypothyroidism and pregnancy – Amiodarone-Induced Neonatal Hypothyroidism: A Unique Form of Transient Early-Onset Hypothyroidism

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David Stewart
Wednesday, September 13, 2017
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  • This is a preview of subscription content, access via your institution. Environmental iodine intake and thyroid dysfunction during chronic amiodarone therapy.

  • Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy.

  • Transient neonatal hypothyroidism after gestational exposure to amiodarone: a follow-up of two cases. Man E.

  • Congenital hypothyroid goiter and amiodarone. Amiodarone-induced hyperthyroidism: a case series and brief review of literature.

INTRODUCTION

Thank you for visiting nature. You are using a browser version pregnanct limited support for CSS. The use of amiodarone during pregnancy for maternal or fetal dysrhythmias may lead to transient neonatal hypothyroidism, usually not associated with goiter. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer.

  • Similar to spontaneous hypothyroidism, AIH patients frequently have vague symptoms and signs, such as fatigue, cold intolerance, mental sluggishness, and dry skin

  • Published : 27 May Am Heart J ;

  • Wladimiroff J. Download references.

  • J Endocrinol Invest 12 : 37 —

  • J Endocrinol Invest 16 : —

Lomenick, J. Exposure to amiodarone may also be associated with neurodevelopmental abnormalities, even in the absence of thyroid disease, but completely normal development has also been reported. At 21 months of age, his development is delayed. Two of the toddlers had transient thyroid abnormalities one with hypothyroidism and one with hyperthyroidism. AM-induced thyrotoxicosis AIT occurs at any time during treatment, preferentially in iodine-deficient regions and in males. Issue Date : 01 June The two toddlers with transient thyroid abnormalities had similar test scores as the rest of the group.

Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. Haffajee C. Regulation of beta-adrenoceptors by thyroid hormone and amiodarone in rat myocardiac cells in culture. The two older children had normal IQ scores but had variable deficiencies in other areas of testing.

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Arch Fr Pediatr ; 49 — Thyroid ; 11 5 — CAS Google Scholar. Substantial transplacental passage of both amiodarone and its metabolite desethylamiodarone occurs. Transient fetal hypothyroidism due to direct fetal administration of amiodarone for drug resistant fetal tachycardia.

  • LaFranchi S. Neuropsychological follow-up in early treated congenital hypothyroidism: a problem oriented approach.

  • Gov't Review.

  • Br Heart J 72 : — Br J Clin Pharmacol 31 : —

  • Physical examination at birth was normal.

  • Effects of amiodarone therapy on thyroid iodine content as measured by X-ray fluorescence.

View author publications. Widerhorn J. The finding that amiodarone treatment may be associated with an increase in certain lymphocyte subsets may indicate, however, that in susceptible individuals amiodarone may precipitate or exacerbate preexisting organ-specific autoimmunity TSH-receptor antibody assessed by the increase in adenylate-cyclase activity in 46 patients with AIT and in 35 normal controls.

  • Amiodarone-associated thyroid dysfunction. Serum interleukin-6 in amiodarone-induced thyrotoxicosis.

  • Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy.

  • Most type II patients will remain euthyroid after resolution of the thyrotoxicosis; some of them may eventually develop hypothyroidism, either spontaneously or after reexposure to iodine 89 ,

  • J Clin Endocrinol Metab 78 : — Trip MDDuren DRWiersinga WM Two cases of amiodarone-induced thyrotoxicosis successfully treated with a short course of antithyroid drugs while amiodarone was continued.

  • One toddler who was euthyroid had delayed Denver developmental milestones and had the lowest Bayley and Reynell scores, and at 3-year follow-up, he had moderate delays in speech, language, and motor skills. Hypothyroidism was transient in all cases, and only 5 infants were treated short-term with thyroid hormones.

  • Internal and Emergency Medicine

Internal and Emergency Medicine Neonatal hypothyroidism after amiodarone therapy during pregnancy]. Thus, fetal amiodarone exposure may lead indufed neurodevelopmental abnormalities in some children. Amiodarone and fetal SVT. Am Heart J ; We describe two cases of transient neonatal hypothyroidism due to in utero amiodarone exposure, followed by a brief review of the available literature. Lomenick, J.

Exposure amiodarone induced hypothyroidism and pregnancy amiodarone may also be associated with neurodevelopmental pregnzncy, even in the absence of thyroid disease, but completely normal development has also been reported. The second infant was born at 36 weeks gestation by spontaneous vaginal delivery. Amiodarone, a benzofuran derivative, is a very effective antiarrhythmia drug. Am Heart J ; Am Heart J ; — Skip to main content Thank you for visiting nature. Amiodarone is an iodine-rich drug used to treat cardiac dysrhythmias.

Publication types

Acta Cardiol 36 : — Neurodevelopment in infants and preschool children with congenital hypothyroidism: etiological and treatment factors affecting outcome. Treatment of amiodarone associated thyrotoxicosis by simultaneous administration of potassium perchlorate and methimazole. Fulgencio J. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmias.

  • Substantial transplacental passage of both amiodarone and its metabolite desethylamiodarone occurs.

  • In all cases, the thyroid abnormality was transient.

  • Thus, it is our policy to continue amiodarone and to treat with l -T 4often requiring larger doses of l -T 4 to normalize the serum TSH in view of the inhibitory effects of amiodarone on T 4 conversion to T 3.

  • J Clin Invest 83 : — Haffajee C.

Amiodarone was used for treatment pregnajcy both maternal and fetal dysrhythmias. Am J Perinatol ; 18 — Pediatric Cardiology There were eight toddlers mean age 18 months and two older children aged 9 and 12 years. Publication types Review. With amiodarone therapy during pregnancy, the fetus is exposed to excess iodine, because like with iodine, transplacental transfer of amiodarone and desethylamiodarone occur. Download references.

Reprints and Permissions. Toxicology65 : — Amiodarone was given directly to pregnanccy fetus via the umbilical vein in only three cases. Environmental iodine intake and thyroid dysfunction during chronic amiodarone therapy. Fisher D. Further support to the concept that this form of AIT, defined as type II 79 Table 4is related to a thyroid-destructive process is provided by the histopathological examination of the thyroids of a few patients. Amiodarone and digoxin for refractory fetal tachycardia.

I. Introduction

Ann Intern Med : — Increase in a new monoclonal antibody-defined T cell subset. This suggests that in patients with an underlying thyroid disorder and residing in a mildly iodine-deficient area, the thyroid gland may fail to adapt normally to the excess iodine load, resulting in inappropriately elevated RAIU values despite the presence of excess plasma iodine. LaFranchi S.

  • Wellers S. Arnoux P.

  • Outcome of thyroid function in newborns from mothers treated with amiodarone. CAS Google Scholar.

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  • Amiodarone and fetal SVT.

J Endocrinol Invest 10 : — Accumulation of amiodarone in the different tissues and the long terminal half-lives of amiodarone and its metabolites 15 hypothryoidism important factors for the occurrence of the above changes. Amiodarone induced hypothyroidism and pregnancy of a case with neonatal hypothyroidism]. In a study of 58 consecutive euthyroid patients residing in a Dutch region with moderately sufficient iodine intake, AIT occurred in Prevalence of amiodarone-induced hyperthyroidism and hypothyroidism in an iodine-deficient area of Northern Tuscany, Italy, and in an iodine-sufficient area of Worcester, Massachusetts. In a recent long-term follow-up of eight toddlers exposed transplacentally to amiodarone, all subjects had normal social competence and favorable global IQ scores, but showed some problems in reading comprehension, written language, and arithmetic, a picture reminiscent of the Nonverbal Learning Disability Syndrome

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Contribution of maternal thyroxine to fetal thyroxine pools in normal thyroids and pregnancy term. Therefore, hypothyroixism II AIT appears to be a form of destructive thyroiditis with associated leakage of preformed hormones from damaged follicles. Thyroid 5 : — Humoral thyroid autoimmunity seems to play little, if any, role in the development of AIT in patients without underlying thyroid disorders. Foster C. Wiener Med Wochenschr 18 : — Amiodarone to prevent recurrence of atrial fibrillation.

Neurotoxicol Teratol ; 21 — Effects of amiodarone administration during pregnancy on neonatal thyroid function and subsequent neurodevelopment. Amiodarone is an iodine-rich drug used to treat cardiac dysrhythmias. If breast-feeding is allowed, careful evaluation of the infant's thyroid function and morphology is required because of the continuing exposure of the infant to the drug. The usefulness of periodic TSH measurement every 6 months during AM treatment is limited by the often sudden explosive onset of AIT, and the spontaneous return of a suppressed TSH to normal values in half of the cases. Amiodarone was given directly to the fetus via the umbilical vein in only three cases. Thyroid ; 11 5 —

Publication types

Pregnancy outcome after gestational exposure to amiodarone in Canada. Abstract Amiodarone is a benzofuranic-derivative iodine-rich drug widely used for the treatment of tachyarrhythmias and, to a lesser extent, of ischemic heart disease. Short term administration of potassium perchlorate restores euthyroidism in amiodarone iodine-induced hypothyroidism.

Thyroid ; 11 5 — J Gynecol Obstet Biol Reprod ; 17 J Perinatol 24, — In all cases, the thyroid abnormality was transient. There were eight toddlers mean age 18 months and two older children aged 9 and 12 years.

In these inducsd amiodarone may be continued since the AIT seems to be self-limited. Plasmapheresis, aimed at removing the excess thyroid hormones from the circulation, has been reported to be efficaciousbut this is usually transient and followed by an exacerbation of AIT Transient neonatal hypothyroidism after gestational exposure to amiodarone: a follow-up of two cases. Google Scholar PubMed. Amiodarone-induced thyrotoxicosis AIT appears to occur more frequently in geographical areas with low iodine intake, whereas AIH is more frequent in iodine-sufficient areas 62 — During long-term amiodarone therapy, clinically euthyroid patients may show modest increases or decreases in serum TSH concentration, possibly reflecting episodes of subclinical hypo- or hyperthyroidism, respectively.

Effect of amiodarone on serum triiodothyronine, reverse triiodothyronine, thyroxin, and thyrotropin. Fisher D. The combined treatment was associated with a transient rise in serum thyroid hormone levels and urinary iodine excretion Long-term effects of L-thyroxine therapy for congenital hypothyroidism.

INTRODUCTION

One toddler who was euthyroid had delayed Denver developmental milestones and had the lowest Ppregnancy and Reynell scores, and at 3-year follow-up, he had moderate delays in speech, language, and motor skills. An Med Interna ; 9 He babbles occasionally but says no definite words and cannot follow simple commands. Neither cumulative amiodarone dose nor duration of amiodarone exposure was related to development of hypothyroidism in the fetus.

Am J Obstet Gynecol ; — Substantial transplacental passage of both amiodarone and its metabolite desethylamiodarone occurs. J Endocrinol Invest ; 24 — Value of amiodarone in the treatment of fetal supraventricular tachycardia. Amiodarone was used for treatment of both maternal and fetal dysrhythmias.

Hidaka Y. Neurodevelopment after in utero amiodarone exposure. The rationale inudced this treatment resides in the fact that potassium perchlorate inhibits thyroid iodide uptake, thereby blocking further entrance of iodide into the thyroid and decreasing the inhibitory effect of excess intrathyroidal iodine. In addition, even discontinuation of amiodarone therapy does not prevent a continuing effect on the thyroid due to its long half-life. Maternal thyroid deficiency during pregnancy and subsequent neupsychological development of the Child.

Breast-feeding was associated with a substantial ingestion of amiodarone by the infant, but in the few cases followed it did not cause changes in the newborn's thyroid function. Am J Cardiol ; 60 Internal and Emergency Medicine

  • Thyroid 7 : — J Gynecol Obstet Biol Reprod ; 16 —

  • A technetium scan revealed intense uptake of tracer in a bilobed thyroid gland in the usual position in the neck, making a diagnosis of amiodarone-induced hypothyroidism most likely. Acta Paediatr Scand ; 77 —

  • Amiodarone inhibits the conversion of thyroxine to triiodothyronine in isolated rat hepatocytes.

Further support to amiodarone induced hypothyroidism and pregnancy concept that this form of AIT, defined as type II 79 Table 4is related to a thyroid-destructive process is provided by the histopathological examination of the thyroids of a few patients. The hypothesis of a defect in the hormonogenetic process seems to be tenable in view of the observation that these patients have a positive perchlorate discharge test, indicating a defect in iodine organification 64 Pop V. Outcome of thyroid function in newborns from mothers treated with amiodarone. Pregnancy outcome after gestational exposure to amiodarone in Canada.

AIT is primarily related to excess iodine-induced thyroid hormone synthesis in an abnormal thyroid amiodarone induced hypothyroidism and pregnancy type I AIT or to amiodarone-related destructive thyroiditis type II AITbut mixed forms frequently exist. Serum Pregnqncy 4 concentrations are often at the upper limit of the normal range, but may be increased, especially in patients receiving higher daily doses of the drug Mandel S. Amiodarone treatment in pregnancy for dilatative cardiomyopathy with ventricular malignant extrasystole and normal maternal and neonatal outcome. As noted earlier, serum T 4 is often in the high normal range or slightly elevated during amiodarone therapy. Article Contents Abstract. In these patients amiodarone may be continued since the AIT seems to be self-limited.

Laboratory findings are similar to those in spontaneous hypothyroidism, with decreased serum free T 4 and increased serum TSH concentrations J Clin Invest 83 : — Hypothyroidism and was last seen at 4 months of age, and his development, growth parameters, physical examination, and thyroid function tests were all normal. Substances Amiodarone. In addition, even discontinuation of amiodarone therapy does not prevent a continuing effect on the thyroid due to its long half-life. Amiodarone-induced hyperthyroidism: a case series and brief review of literature. Neurodevelopment assessment of the hypothyroid infants, when carried out, showed in some instances mild abnormalities, most often reminiscent of the Non-verbal Learning Disability Syndrome; however, these features were also reported in some amiodarone-exposed euthyroid infants, suggesting that there might be a direct neurotoxic effect of amiodarone during fetal life.

The use of amiodarone during amiodqrone for maternal or fetal dysrhythmias may lead to transient neonatal hypothyroidism, usually not associated with goiter. Transient fetal hypothyroidism due to direct fetal administration of amiodarone for drug resistant fetal tachycardia. Thus, fetal amiodarone exposure may lead to neurodevelopmental abnormalities in some children. Advanced search.

Pattern 0, Absent hypervascularity; pattern I, presence of parenchymal blood flow with patchy uneven distribution ; pattern II, mild increase hypothyroiddism color flow Doppler signal with patchy distribution ; pattern III, markedly increased color flow Doppler signal with diffuse homogeneous distribution. Am J Cardiol 51 : — A technetium scan revealed intense uptake of tracer in a bilobed thyroid gland in the usual position in the neck, making a diagnosis of amiodarone-induced hypothyroidism most likely. Lancet1 : —

Pfegnancy term administration of potassium perchlorate restores euthyroidism in amiodarone iodine-induced hypothyroidism. Effects hypothyroidism and pregnancy amiodarone administration during pregnancy in Fischer rats. The structure of amiodarone resembles that of thyroxine, and treatment with amiodarone may alter thyroid function. Preoperative amiodarone as prophylaxis against atrial fibrillation after heart surgery. Transient fetal hypothyroidism due to direct fetal administration of amiodarone for drug resistant fetal tachycardia. Am J Cardiol 58 : —

Am J Cardiol ; 60 Exposure to amiodarone may also be associated with neurodevelopmental abnormalities, even in the absence of thyroid disease, but completely normal development has also been reported. We describe two cases of transient neonatal hypothyroidism due to in utero amiodarone exposure, followed by a brief review of the available literature.

  • Gembruch U.

  • J Gynecol Obstet Biol Reprod ; 16 —

  • J Clin Endocrinol Metab 62 : —

MoffettSantiago O. Neurotoxicol Teratol ; 21 — The heart rate was regular, without tachycardia. CAS Google Scholar. Breast-feeding was associated with a substantial ingestion of amiodarone by the infant, but in the few cases followed it did not cause changes in the newborn's thyroid function.

Hypothyroodism development at 7 years of age in children with congenital hypothyroidism: timing and dosage of initial treatment. Springer Verlag, Berlin, pp — Value of amiodarone in the treatment of fetal supraventricular tachycardia. Amiodarone, its main metabolite desethylamiodarone and iodine are transferred, albeit incompletely, through the placenta, resulting in a relevant fetal exposure to the drug and iodine overload.

MoffettSantiago O. Limited data are available inducfd the long-term neuropsychological development of infants exposed to amiodarone during pregnancy, with only anecdotal data for those with amiodarone-induced hypothyroidism 91011121718 Table 1. There are 69 reported cases of amiodarone use during pregnancy in which the infants' thyroid function was documented. This may be due to a direct neurotoxic effect of amiodarone on the fetal brain. At 21 months of age, his development is delayed. AIT is associated with a higher rate of major adverse cardiovascular events especially of ventricular arrhythmias. The two toddlers with transient thyroid abnormalities had similar test scores as the rest of the group.

J Clin Endocrinol Metab 75 : — Effect of amiodarone on serum triiodothyronine, reverse triiodothyronine, thyroxin, and thyrotropin. Wolff J Perchlorate and the thyroid gland. Bartalena L. Chemical formula of amiodarone, DEA, and thyroid hormones.

The infant did well in the perinatal period, but he was admitted on day of life 6 for tachycardia and an apneic spell at home. AIT can be classified in type 1 iodide-induced thyrotoxicosis, best treated by potassium perchlorate in combination with thionamides and discontinuation of AM and type 2 destructive thyrotoxicosis, best treated by prednisone; discontinuation of AM may not be necessary. The mechanism of amiodarone-induced hypothyroidism is most likely related to the Wolff—Chaikoff effect, 2 the process of decreased oxidation and coupling of iodine to thyroglobulin organification with increasing doses of iodine. However, the contribution of maternal cardiac disease, other maternal medications, and fetal thyroid insufficiency cannot be ruled out.

View author publications. The heart rate was regular, without tachycardia. Orphanet Journal of Rare Diseases Use of amiodarone during pregnancy. An Med Interna ; 9

J Gynecol Obstet Biol Reprod ; 16 — The mechanism of amiodarone-induced hypothyroidism is most likely related to the Wolff—Chaikoff effect, 2 the process of decreased oxidation and coupling of iodine to thyroglobulin organification with increasing doses of iodine. Search Search articles by subject, keyword or author.

Hyperthyroxinemia with bradycardia and normal thyrotropin secretion after chronic amiodarone administration. Short term administration of potassium perchlorate restores euthyroidism in amiodarone iodine-induced hypothyroidism. Eur J Endocrinol : — Amiodarone and the thyroid. Eur J Clin Invest 14 : —

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Transient fetal hypothyroidism due to direct fetal administration of amiodarone for drug resistant fetal tachycardia. Thyroid ; 11 5 — Hypothuroidism two toddlers with amiodarone induced hypothyroidism and pregnancy thyroid abnormalities had similar test scores as the rest of the group. In all cases, the thyroid abnormality was transient. The infant did well in the perinatal period, but he was admitted on day of life 6 for tachycardia and an apneic spell at home. AM-induced hypothyroidism develops rather early after starting treatment, preferentially in iodine-sufficient areas and in females with TPO-Ab; it is due to failure to escape from the Wolff-Chaikoff effect, resulting in preserved radioiodine uptake.

  • Oppenheimer J.

  • While he is able to feed himself with a fork or spoon, he just began walking independently.

  • The effects of plasmapheresis on thyroid hormone and plasma drug concentrations in amiodarone-induced thyrotoxicosis.

  • Neither cumulative amiodarone dose nor duration of amiodarone exposure was related to development of hypothyroidism in the fetus. There was no goiter.

  • Download references. Endocrinologist4 : —

We describe two cases of transient neonatal hypothyroidism due to in utero amiodarone exposure, followed by a brief review of the available literature. Neurotoxicol Teratol ; 21 — This may be due to a direct neurotoxic effect of amiodarone on the fetal brain. There was no goiter.

If breast-feeding is allowed, careful evaluation of the infant's thyroid function and morphology is required because of the continuing exposure of the infant to the drug. The infant did well in the perinatal period, but amiodaorne was admitted on day of life 6 for tachycardia and an apneic spell at home. They might be related to a down-regulation of thyroid hormone receptors TR caused by amiodarone. Refractoriness to antiarrhythmic therapy may reflect the development of AIT. If the serum TSH becomes low and the serum T 4 and T 3 do not rise above previous values on amiodarone and the patient remains clinically euthyroid, more frequent evaluations are necessary but definitive therapy should be withheld. Becks G.

You are using a browser version with limited support for CSS. Download PDF. J Perinatol 24, — Article Google Scholar.

Hypothyroidism was transient in all cases, and only 5 infants were treated short-term with thyroid hormones. Advanced search. Neurotoxicol Teratol ; 21 — The two older children had normal IQ scores but had variable deficiencies in other areas of testing. Breast-feeding was associated with a substantial ingestion of amiodarone by the infant, but in the few cases followed it did not cause changes in the newborn's thyroid function. The structure of amiodarone resembles that of thyroxine, and treatment with amiodarone may alter thyroid function. A brain MRI and hearing test were normal.

Issue Date : 01 June Haffajee CI. Gov't Review. Am J Cardiol ; 60 AM-induced thyrotoxicosis AIT occurs at any time during treatment, preferentially in iodine-deficient regions and in males. An Med Interna ; 9 You can also search for this author in PubMed Google Scholar.

Acute effects of amiodarone administration on thyroid function in patients with cardiac arrhythmia. Amiodarone-induced hyperthyroidism: thyroidectomy under local anesthesia. Apropos of a case]. Hidaka Y.

Thyroid ; 2 — Effects of amiodarone administration during pregnancy on neonatal thyroid function and subsequent neurodevelopment. He babbles occasionally but says no definite words and cannot follow simple commands. Substantial transplacental passage of both amiodarone and its metabolite desethylamiodarone occurs. Prenat Diagn ; 14 —

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SeslarMichelle M. The structure of amiodarone resembles that of thyroxine, and treatment with amiodarone may alter thyroid function. Interestingly, these autoantibodies, appearing early during amiodarone treatment, could no longer be detected 6 months after withdrawal of the drug Vicens-Calvet E. School attainments in children with congenital hypothyroidism detected by neonatal screening and treated early in life.

While he amiodarone induced hypothyroidism and pregnancy able to feed himself with a fork or spoon, he just began walking independently. Am J Obstet Gynecol ; — Google Scholar 7 Haffajee CI. There was no goiter. The eight toddlers as a group had normal scores on Bayley and Reynell neurodevelopment testing compared with controls. The two older children had normal IQ scores but had variable deficiencies in other areas of testing. Neonatal hypothyroidism after treatment by amiodarone during pregnancy.

Am J Cardiol 60 : Enhanced susceptibility to amiodarone-induced hypothyroidism in patients with thyroid autoimmune disease. Haddow J. Matsumura L. Shorter periods of perchlorate therapy 8 days seem to result in a high risk of recurrent thyrotoxicosis Perelman A.

Apropos of a case with neonatal hypothyroidism]. The eight toddlers as a group had normal scores on Bayley and Reynell neurodevelopment testing compared with controls. Amiodarone therapy of intractable atrial flutter in a premature hydropic neonate.

Abstract Amiodarone prgnancy an iodine-rich amiodarone induced hypothyroidism and pregnancy used to treat cardiac dysrhythmias. Pediatric Cardiology You can also search for this author in PubMed Google Scholar. The mechanism of amiodarone-induced hypothyroidism is most likely related to the Wolff—Chaikoff effect, 2 the process of decreased oxidation and coupling of iodine to thyroglobulin organification with increasing doses of iodine. He has subsequently been lost to follow-up.

Perelman Amiodarone induced hypothyroidism and pregnancy. Branawig J. These patients usually have no detectable thyroid abnormalities on physical amiodaone or ultrasonography, although in some cases there may be a small, tender goiter, and thyroid autoantibody tests are negative. Abstract Amiodarone, a benzofuranic derivative, iodine-rich drug, has been used in pregnancy for either maternal or fetal tachyarrhythmias. If amiodarone cannot be withdrawn and medical therapy is unsuccessful, consider total thyroidectomy.

It is unrelated to either the dose or duration of amiodarone treatment. Neurodevelopment assessment of the hypothyroid infants, when carried out, showed in some instances mild abnormalities, most often reminiscent of the Non-verbal Learning Disability Syndrome; however, these features were also reported in some amiodarone-exposed euthyroid infants, suggesting that there might be a direct neurotoxic effect of amiodarone during fetal life. The second infant was born at 36 weeks gestation by spontaneous vaginal delivery. Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy. You are using a browser version with limited support for CSS. One toddler who was euthyroid had delayed Denver developmental milestones and had the lowest Bayley and Reynell scores, and at 3-year follow-up, he had moderate delays in speech, language, and motor skills.

In dogs, thyroid subcellular changes were not observed after a single, high-dose intravenous amiodarone injection, while they became apparent after multiple injections for 1 week Arnoux P. This possibility should be reevaluated using recombinant human TSH.

Show results from All journals This journal. This may be due to a direct neurotoxic effect of amiodarone on the fetal brain. The pregnancy was complicated by fetal supraventricular tachycardia, first diagnosed at 31 weeks gestation. The eight toddlers as a group had normal scores on Bayley and Reynell neurodevelopment testing compared with controls. Internal and Emergency Medicine

  • North Am.

  • Pregnancy outcome after gestational exposure to amiodarone in Canada. You can also search for this author in PubMed Google Scholar.

  • AIH usually develops earlier than AIT, both in patients with apparently normal thyroid glands and in patients with preexisting thyroid abnormalities 4464—

  • Congenital hypothyroid goiter and amiodarone.

  • Internal and Emergency Medicine Med J Aust : —

These patients usually have no detectable thyroid abnormalities on physical examination or ultrasonography, although in some cases there may be a small, tender goiter, and thyroid autoantibody tests are negative. About this article Cite this article Bartalena, L. Bartalena et al. Amiodarone, thyroid hormone indexes, and altered thyroid function: long-term serial effects in patients with cardiac arrhythmias.

Horm Metab Res 22 : 85 — Br Heart J 72 : — aamiodarone Iodine kinetic studies during amiodarone treatment. Chemically induced birth defects. Amiodarone, if absolutely necessary, can be administered to pregnant women, but thyroid function in the neonate must be carefully monitored because of the possible occurrence of AIH. The identification of two main subtypes of AIT and of the respective pathogenic mechanisms provides the basis for a rational approach to medical treatment. Serum IL-6 levels b.

You are using a browser version with amiodarone induced hypothyroidism and pregnancy support for CSS. DEA, imduced main amiodarone metabolite, is even more cytotoxic for thyroid cells than amiodarone 31and its intrathyroidal concentration is higher than that of the parental drug Appropriate reference values for thyroid function tests in patients receiving amiodarone are shown in Table 2. Disatnik MHShainberg A Regulation of beta-adrenoceptors by thyroid hormone and amiodarone in rat myocardiac cells in culture.

If amiodarone cannot be withdrawn pdegnancy medical therapy is unsuccessful, consider total thyroidectomy. Amiodarone to prevent recurrence of atrial fibrillation. Both mechanisms contribute to the increased serum T 4 concentration and the decreased serum T 3 concentration in euthyroid subjects given long-term amiodarone therapy 910 — Search SpringerLink Search. Matsumura L.

Antepartum diagnosis of goitrous hypothyroidism by fetal ultrasonography and amniotic fluid thyrotropin concentration. Its use is associated with variations in thyroid function tests that do not reflect true changes in thyroid status. Klin Wochenschr 63 : — J Endocrinol Invest 10 : — As noted earlier, serum T 4 is often in the high normal range or slightly elevated during amiodarone therapy.

Thyroid function tests rapidly normalized. However, the contribution of maternal cardiac disease, other maternal medications, and fetal thyroid insufficiency cannot be ruled out. He has subsequently been lost to follow-up. J Endocrinol Invest ; 21 —

Acta Cardiol 44 : — Amico J. Both the above features are typically encountered in thyroid-destructive processes, such as subacute thyroiditis 81 Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy.

Appropriate reference values for thyroid function tests in patients receiving amiodarone are shown in Table 2. Amiodarone induced hypothyroidism and pregnancy effects of plasmapheresis on thyroid hormone and plasma drug concentrations in amiodarone-induced thyrotoxicosis. LaFranchi S. Guilford Publications, New York,p. Vicens-Calvet E. In addition, the drug inhibits thyroid hormone entry into peripheral tissues It is also possible that the cytotoxicity induced by amiodarone would decrease the possibility of a goiter developing while receiving amiodarone.

  • Thionamides with or without potassium perchlorate are not an appropriate form of therapy for type II AIT, which is a destructive thyroiditis induced by amiodarone.

  • In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. The structure of amiodarone resembles that of thyroxine, and treatment with amiodarone may alter thyroid function.

  • J Nucl Med 26 : — Transplacental treatment of tachycardia-induced fetal heart failure with verapamil and amiodarone.

  • Am J Obstet Gynecol ; —

  • The above description of changes in thyroid function tests occurring during chronic amiodarone therapy underscore the important concept that standard thyroid function tests in euthyroid patients receiving amiodarone have a different range than those observed in euthyroid subjects not receiving amiodarone. Vicens-Calvet E.

Prenat Diagn ; 14 — The latter findings might be compatible with the disruption of protein sorting pathways leading to a drug-induced form of endoplasmic reticulum storage disease. J Clin Endocrinol Metab 78 : — School attainments in children with congenital hypothyroidism detected by neonatal screening and treated early in life.

And pregnancy Date : 01 June Am J Obstet Gynecol ; hypothyrokdism AIT can be classified in type 1 iodide-induced thyrotoxicosis, best treated by potassium perchlorate in combination with thionamides and discontinuation of AM and type 2 destructive thyrotoxicosis, best treated by prednisone; discontinuation of AM may not be necessary. He babbles occasionally but says no definite words and cannot follow simple commands. Neurotoxicol Teratol ; 21 —

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