BACKGROUND: Amiodarone-induced thyrotoxicosis (AIT) may be caused by excessive thyroidal hormone synthesis and release (type 1) or by a destructive process (type 2). This differentiation is considered essential for therapeutic choice. PURPOSE: To evaluate the utility of color-flow Doppler sonography (CFDS) in the differential diagnosis and management of AIT. MATERIAL AND METHODS: The clinical and laboratory data, thyroid sonography (grayscale sonography [GSS], CFDS), thyroid radioiodine uptake (RAIU) and thyroid scintigraphy, treatment, and clinical outcome were retrospectively reviewed in 21 AIT patients. The CFDS pattern of thyroid nodules was separately described from that of the perinodular parenchyma, and AIT was classified as type 1 (increased blood flow) or type 2 (low/no blood flow). Type 1 AIT patients were treated with methimazole (alone or associated with potassium perchlorate), while type 2 patients were treated with prednisone or amiodarone withdrawal alone. RESULTS: Eleven patients with increased blood flow were considered as type 1, and 10 with low/no blood flow as type 2. Ten of the 11 patients in the first group showed a hypervascular nodular pattern, while one showed a hypervascular parenchymal pattern. Clinical diagnoses were toxic nodular goiter and Graves' disease, respectively. Of the 10 patients with low/no blood flow, six had normal thyroid volume, three small diffuse goiter, and one small multinodular goiter. The clinical outcome showed that 20 of the 21 patients were treatment responsive. CONCLUSION: CFDS is a useful tool in the differential diagnosis of AIT. This differentiation appeared to be of clinical relevance as regards therapeutic choice. Separate evaluation of parenchymal blood flow from that of nodules may prove beneficial in the diagnosis of underlying thyroid diseases in patients with type 1 AIT.
BACKGROUND:Amiodarone-induced thyrotoxicosis (AIT) may be caused by excessive thyroidal hormone synthesis and release (type 1) or by a destructive process (type 2). This differentiation is considered essential for therapeutic choice. PURPOSE: To evaluate the utility of color-flow Doppler sonography (CFDS) in the differential diagnosis and management of AIT. MATERIAL AND METHODS: The clinical and laboratory data, thyroid sonography (grayscale sonography [GSS], CFDS), thyroid radioiodine uptake (RAIU) and thyroid scintigraphy, treatment, and clinical outcome were retrospectively reviewed in 21 AIT patients. The CFDS pattern of thyroid nodules was separately described from that of the perinodular parenchyma, and AIT was classified as type 1 (increased blood flow) or type 2 (low/no blood flow). Type 1 AIT patients were treated with methimazole (alone or associated with potassium perchlorate), while type 2 patients were treated with prednisone or amiodarone withdrawal alone. RESULTS: Eleven patients with increased blood flow were considered as type 1, and 10 with low/no blood flow as type 2. Ten of the 11 patients in the first group showed a hypervascular nodular pattern, while one showed a hypervascular parenchymal pattern. Clinical diagnoses were toxic nodular goiter and Graves' disease, respectively. Of the 10 patients with low/no blood flow, six had normal thyroid volume, three small diffuse goiter, and one small multinodular goiter. The clinical outcome showed that 20 of the 21 patients were treatment responsive. CONCLUSION: CFDS is a useful tool in the differential diagnosis of AIT. This differentiation appeared to be of clinical relevance as regards therapeutic choice. Separate evaluation of parenchymal blood flow from that of nodules may prove beneficial in the diagnosis of underlying thyroid diseases in patients with type 1 AIT.
Authors: Elke Anklam; Martin Iain Bahl; Robert Ball; Richard D Beger; Jonathan Cohen; Suzanne Fitzpatrick; Philippe Girard; Blanka Halamoda-Kenzaoui; Denise Hinton; Akihiko Hirose; Arnd Hoeveler; Masamitsu Honma; Marta Hugas; Seichi Ishida; George En Kass; Hajime Kojima; Ira Krefting; Serguei Liachenko; Yan Liu; Shane Masters; Uwe Marx; Timothy McCarthy; Tim Mercer; Anil Patri; Carmen Pelaez; Munir Pirmohamed; Stefan Platz; Alexandre Js Ribeiro; Joseph V Rodricks; Ivan Rusyn; Reza M Salek; Reinhilde Schoonjans; Primal Silva; Clive N Svendsen; Susan Sumner; Kyung Sung; Danilo Tagle; Li Tong; Weida Tong; Janny van den Eijnden-van-Raaij; Neil Vary; Tao Wang; John Waterton; May Wang; Hairuo Wen; David Wishart; Yinyin Yuan; William Slikker Journal: Exp Biol Med (Maywood) Date: 2021-11-16
Authors: Georgios K Markantes; Marina A Michalaki; George A Vagenakis; Fotini N Lamari; Efthymia Pitsi; Maria Eliopoulou; Nicholas G Beratis; Kostas B Markou Journal: Eur Thyroid J Date: 2019-07-15