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World Journal of Surgery

, Volume 22, Issue 6, pp 537–543 | Cite as

Surgical Management of Amiodarone-associated Thyrotoxicosis: Too Risky or Too Effective?

  • Etienne Hamoir
  • Michel Meurisse
  • Thierry Defechereux
  • Jean Joris
  • Janine Vivario
  • Georges Hennen
  • 54 Downloads

Abstract. Amiodarone-associated thyrotoxicosis, often clinically mild and resolutive after amiodarone discontinuation or under medical therapy, is sometimes drug unresponsive and not uncommonly follows a dramatic, even fatal course. Therefore, we considered a surgical solution in 15 severely amiodarone-associated thyrotoxic patients. Twelve men and three women (mean age 68 years, range 50–84 years) underwent radical thyroidectomy for clinical and biologically proved amiodarone-associated thyrotoxicosis. In six surgery was the first-line therapeutic option. In the other nine thyroidectomy seemed unavoidable considering the unresponsiveness to medical therapy and rapid deterioration of the patients’ clinical condition, with life-threatening cardiac failure in three. In every patient surgery was conducted without immediate or delayed complications. Total thyroidectomy proved uniformly, definitively, and rapidly effective in controlling thyrotoxicosis in all patients, with a spectacular reversal of cardiac failure in the three most critical cases. Surgery was beneficial to our 15 patients and undoubtedly life-saving in the three most worrying cases. These results suggest that thyroidectomy should be more liberally regarded as an interesting alternative to conventional, but unpredictably effective, medical therapies.

Keywords

Clinical Condition Medical Therapy Therapeutic Option Amiodarone Thyrotoxicosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirugie 1998

Authors and Affiliations

  • Etienne Hamoir
    • 1
  • Michel Meurisse
    • 1
  • Thierry Defechereux
    • 1
  • Jean Joris
    • 2
  • Janine Vivario
    • 3
  • Georges Hennen
    • 4
  1. 1.Department of Surgery, Division of Endocrine Surgery, University of Liege, Domaine Universitaire du Sart-Tilman, B35, 4000 Liege, BelgiumBE
  2. 2.Department of Anesthesiology, University of Liege, Domaine Universitaire du Sart-Tilman B35, 4000 Liege, BelgiumBE
  3. 3.Department of Pathology, University of Liege, Domaine Universitaire du Sart-Tilman B35, 4000 Liege, BelgiumBE
  4. 4.Department of Endocrinology, University of Liege, Domaine Universitaire du Sart-Tilman B35, 4000 Liege, BelgiumBE

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