Glucocorticoid Response in Amiodarone-Induced Thyrotoxicosis Resulting from Destructive Thyroiditis Is Predicted by Thyroid Volume and Serum Free Thyroid Hormone Concentrations (Articolo in rivista)

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  • Glucocorticoid Response in Amiodarone-Induced Thyrotoxicosis Resulting from Destructive Thyroiditis Is Predicted by Thyroid Volume and Serum Free Thyroid Hormone Concentrations (Articolo in rivista) (literal)
Anno
  • 2007-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.1210/jc.2006-2059 (literal)
Alternative label
  • Fausto Bogazzi; Luigi Bartalena; Luca Tomisti; Giuseppe Rossi; Maria Laura Tanda; Enrica Dell'Unto; Fabrizio Aghini-Lombardi; and Enio Martino (2007)
    Glucocorticoid Response in Amiodarone-Induced Thyrotoxicosis Resulting from Destructive Thyroiditis Is Predicted by Thyroid Volume and Serum Free Thyroid Hormone Concentrations
    in The Journal of clinical endocrinology and metabolism; Endocrine Society, Chevy Chase (Stati Uniti d'America)
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Fausto Bogazzi; Luigi Bartalena; Luca Tomisti; Giuseppe Rossi; Maria Laura Tanda; Enrica Dell'Unto; Fabrizio Aghini-Lombardi; and Enio Martino (literal)
Pagina inizio
  • 556 (literal)
Pagina fine
  • 562 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume
  • 92 (literal)
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  • 7 (literal)
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  • 2 (literal)
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  • ubMe (literal)
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  • Department of Endocrinology and Metabolism (F.B., L.T., E.D., F.A.-L., E.M.), University of Pisa, 56124 Pisa, Italy; Department of Clinical Medicine (L.B., M.L.T.), University of Insubria, 21100 Varese, Italy; Unit of Epidemiology and Biostatistics (G.R.), Institute of Clinical Physiology, National Research Council (CNR), 56100 Pisa, Italy (literal)
Titolo
  • Glucocorticoid Response in Amiodarone-Induced Thyrotoxicosis Resulting from Destructive Thyroiditis Is Predicted by Thyroid Volume and Serum Free Thyroid Hormone Concentrations (literal)
Abstract
  • Context: Amiodarone-induced thyrotoxicosis (AIT) resulting from destructive thyroiditis (type 2) is commonly treated with glucocorticoids, but time needed to restore euthyroidism may be unacceptable for patients with underlying cardiac disorders. Objective: The objective of this prospective study was to identify factors affecting the response to glucocorticoids in a large cohort of patients with type 2 AIT followed prospectively. Setting: This study was conducted at university centers. Patients: Sixty-six untreated patients with type 2 AIT were enrolled in the study. Intervention: All patients were treated with prednisone (initial dose, 0.5 mg/kg?d) as long as needed to restore euthyroidism, defined as cure of AIT. Main Outcome Measure: The main outcome measure was cure time. Results: The median cure time was 30 d (95% confidence interval, 23-37 d). Serum free T4 concentration (picograms per milliliter) and thyroid volume (milliliters per square meter) (and, to a lesser extent, serum free T3 concentration) at diagnosis were the main determinants of response to glucocorticoids, with a cure hazard ratio of 0.97 (95% confidence interval, 0.95-0.99; P ? 0.005) and 0.84 (95% confidence interval, 0.77-0.91; P ? 0.000) for unit of increment, respectively. AIT was cured in all patients with a complete follow-up; euthyroidism was reached in 30 d or less in 60% of patients but in more than 90 d in 16%. A prompt control of thyrotoxicosis (?30 d of treatment) was more frequent (77%) in patients with serum basal free T4 concentration no greater than 50 pg/ml and thyroid volume (normalized for body surface area) no greater than 12 ml/m2. The cure probability and the mean cure time in an individual patient can be obtained using a formula generated by multiple regression models. Conclusions: Baseline serum thyroid hormone concentrations and thyroid volume help identify patients with type 2 AIT at risk of a delayed response to glucocorticoids. (literal)
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