Clinical, biochemical and therapeutical aspects of amiodarone-induced hypothyroidism (AIH) in geriatric patients with cardiac arrhythmias

R. G. Gheri, P. Pucci, C. Falsetti, M. L E Luisi, G. P. Cerisano, C. F. Gheri, I. Petruzzi, P. Pinzani, B. Salvadori, E. Petruzzi

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Abstract

The clinical features and the laboratory aspects of the amiodarone-induced hypothyroidism (AIH) in the elderly as well as the effects of amiodarone treatment in aged AIH people have not yet been well clarified. In the present paper, we evaluated 18 subjects of both sexes (7 females, 11 males), aged 65-83 years, affected by AIH, recruited in Central Tuscany, Italy. The patients were divided in two subsets on the basis of thyroid stimulating hormone (TSH) values: mild (TSH20mU/l; Group B, n=7) hypothyroid patients. On the basis of clinical features, hypothyroidism was diagnosed only in two patients (out of Group B). Concerning the hormonal pattern, we found that free tetraiodothyronine (fT4) levels were significantly lower than the normal range only in Group B subjects; TSH and thyroglobulin were higher than normal in both groups; free triiodothyronine (fT3) were always in the normal range. Thyroid autoantibodies were found positive only in one patient out of Group A and in two patients out of Group B. In 5/18 patients T4 substitutive therapy was rapidly assigned, because of severe degree of hypothyroidism. In the remaining 13/18 patients, we evaluated the clinical behavior of AIH. After additional cardiac evaluation, amiodarone was withdrawn in 5/13 patients: during follow-up period (4-10 months) four patients became quickly euthyroid while one worsened. In 8/13 patients, amiodarone treatment had to be carried on; during follow-up (2-48 months), four patients remained mildly hypothyroid, while other four patients became severely hypothyroid. In conclusion, in amiodarone treated elderly people, diagnosis of hypothyroidism is reliable only on the basis of high values of TSH; clinical features and fT3 serum levels never enable diagnosis.

Original languageEnglish
Pages (from-to)27-36
Number of pages10
JournalArchives of Gerontology and Geriatrics
Volume38
Issue number1
DOIs
Publication statusPublished - Jan 2004

Fingerprint

Amiodarone
geriatrics
Hypothyroidism
Geriatrics
Cardiac Arrhythmias
Group
Thyrotropin
Reference Values
Italy
Thyroglobulin
Triiodothyronine
evaluation
Autoantibodies
Values
Thyroid Gland
Therapeutics

Keywords

  • Amiodarone
  • Elderly subjects
  • Hypothyroidism

ASJC Scopus subject areas

  • Ageing
  • Medicine(all)

Cite this

Clinical, biochemical and therapeutical aspects of amiodarone-induced hypothyroidism (AIH) in geriatric patients with cardiac arrhythmias. / Gheri, R. G.; Pucci, P.; Falsetti, C.; Luisi, M. L E; Cerisano, G. P.; Gheri, C. F.; Petruzzi, I.; Pinzani, P.; Salvadori, B.; Petruzzi, E.

In: Archives of Gerontology and Geriatrics, Vol. 38, No. 1, 01.2004, p. 27-36.

Research output: Contribution to journalArticle

Gheri, R. G. ; Pucci, P. ; Falsetti, C. ; Luisi, M. L E ; Cerisano, G. P. ; Gheri, C. F. ; Petruzzi, I. ; Pinzani, P. ; Salvadori, B. ; Petruzzi, E. / Clinical, biochemical and therapeutical aspects of amiodarone-induced hypothyroidism (AIH) in geriatric patients with cardiac arrhythmias. In: Archives of Gerontology and Geriatrics. 2004 ; Vol. 38, No. 1. pp. 27-36.
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