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

@aakasharmand


#Amiodarone #thyroid #thyrotoxicosis #AIT #Pathology #Clinical #Microscopy