Amiodarone induced thyroid changes
Histopath: Remarkably enlarged follicles, distended with colloid, without
scalloping, and lined by flattened follicular cells. Some follicles contain
numerous foamy macrophages representing destructive change, Follicular cells
cytoplasm can be vacuolated containing yellowish pigment (lipofuscin)
AIT develops in 3% of amiodarone-treated patients in North America
For those living in iodine-depleted areas, the incidence is higher (10%)
This risk also increases with increased dosage
The thyrotoxicosis is mediated by amiodarone's iodine content.
There are two types of AIT, type l and II, which can be distinguished based on history and pertechnetate scanning
Weigh risks vs. benefits when determining cessation of amiodarone.
Alternatives exist if patients do not respond to initial treatment
Thyroidectomy is a reasonable definitive cure, especially if patients have cardiac conditions where they need to remain on amiodarone
- Dr. Zubair Baloch
#Amiodarone #thyroid #thyrotoxicosis #AIT #Pathology #Clinical #Microscopy