Hipertiroidismo inducido por amiodarona

Pérez Parras, M.A.; Marín Patón, M.; Negrillo Cantero, A.M.; Caro Cruz, E.; González Rivera, F.

doi:10.1016/S1695-4033(00)77483-2

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González Rivera" "autores" => array:5 [ 0 => array:4 [ "nombre" => "M.A." "apellidos" => "Pérez Parras" "email" => array:1 [ 0 => "amnegrillo@colmedjaen.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Marín Patón" ] 2 => array:2 [ "nombre" => "A.M." "apellidos" => "Negrillo Cantero" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Caro Cruz" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "González Rivera" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Pediatría. Hospital General de Especialidades Ciudad de Jaén" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Avda. de Andalucía, 35, 1.° B. 23006 Jaén" ] ] ] 1 => array:3 [ "autoresLista" => "A. Moreno Carazo" "autores" => array:1 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Moreno Carazo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Endocrinología. Hospital General de Especialidades Ciudad de Jaén" "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Amiodarone-induced hyperthyroidism" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-31" "fechaAceptado" => "2000-06-30" "PalabrasClave" => array:1 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186469" "palabras" => array:3 [ 0 => "Amiodarone" 1 => "Hyperthyroidism" 2 => "Antiarrhytmics" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186470" "palabras" => array:3 [ 0 => "Hipertirodismo" 1 => "Amiodarona" 2 => "Niños" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "La amiodarona es un fármaco utilizado extensamente en la práctica cardiológica por sus excelentes propiedades antiarrítmicas. Produce alteraciones funcionales tiroideas por su alto contenido en yodo, contiene un 37% de yodo y es estructuralmente similar a las hormonas tiroideas. Produce inhibición hepática de la 5'desyodas.El hipertiroidismo secundario a amiodarona presenta una incidencia ente el 6-12% de los pacientes tratados, siendo en la infancia las cifras de incidencias similares.La determinación de niveles de T3, T4, TSH juegan un papel importante por el seguimiento y diagnóstico de las alteraciones tiroideas.Las opciones de tratamiento del hipertiroidismo inducido por amiodarona en niños incluyen: tionamidas, perclorato potásico y prednisona.Presentamos un caso de hipertiroidismo secundario a amiodarona en un varón de 10 años con síndrome de Marfan que presenta varios ingresos por crisis de taquicardia paroxística supraventricular y fibrilación auricular. Tras tratamiento con amiodarona presenta un cuadro clínico y analítico de hipertiroidismo con cifras de TSH muy disminuidas y de T4 libre aumentadas. La ecografía y gammagrafía tiroideas fueron normales.Se inicia tratamiento con tiamazol no cediendo el cuadro, que se normaliza tras la administración de prednisona. Actualmente se retira lentamente la prednisona" ] "en" => array:1 [ "resumen" => "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 theliver. 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 prednisoneWe 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" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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Anales de Pediatría

ISSN: 1695-4033

La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es una revista de acceso abierto que actúa como el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Anales de Pediatría publica, en inglés y en español, trabajos originales sobre investigación en pediatría, así como artículos de revisión elaborados por los profesionales expertos de cada especialidad, y guías o documentos de posicionamiento elaborados por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría. La revista, referente de la pediatría de habla española, está indexada en las más importantes bases de datos internacionales: Index Medicus/Medline IBECS, IME, SCOPUS, Science Citation Index Expanded, Journal Citations Report, Embase/Excerpta Medica, Directory of Open Access Journals (DOAJ).

In Memoriam: Alfredo García-Alix (1956-2024)

Indexada en:

Index Medicus/Medline IBECS, IME, SCOPUS, Science Citation Index Expanded, Journal Citations Report, Embase/Excerpta Medica, Directory of Open Access Journals (DOAJ)

La amiodarona es un fármaco utilizado extensamente en la práctica cardiológica por sus excelentes propiedades antiarrítmicas. Produce alteraciones funcionales tiroideas por su alto contenido en yodo, contiene un 37% de yodo y es estructuralmente similar a las hormonas tiroideas. Produce inhibición hepática de la 5'desyodas.

El hipertiroidismo secundario a amiodarona presenta una incidencia ente el 6-12% de los pacientes tratados, siendo en la infancia las cifras de incidencias similares.

La determinación de niveles de T3, T4, TSH juegan un papel importante por el seguimiento y diagnóstico de las alteraciones tiroideas.

Las opciones de tratamiento del hipertiroidismo inducido por amiodarona en niños incluyen: tionamidas, perclorato potásico y prednisona.

Presentamos un caso de hipertiroidismo secundario a amiodarona en un varón de 10 años con síndrome de Marfan que presenta varios ingresos por crisis de taquicardia paroxística supraventricular y fibrilación auricular. Tras tratamiento con amiodarona presenta un cuadro clínico y analítico de hipertiroidismo con cifras de TSH muy disminuidas y de T4 libre aumentadas. La ecografía y gammagrafía tiroideas fueron normales.

Se inicia tratamiento con tiamazol no cediendo el cuadro, que se normaliza tras la administración de prednisona. Actualmente se retira lentamente la prednisona

Key words:

Amiodarone

Hyperthyroidism

Antiarrhytmics

Palabras clave:

Hipertirodismo

Amiodarona

Niños

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 theliver. 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

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