Importance of (99)mTc-sestaMIBI thyroid scan in a case of amiodarone-induced thyrotoxicosis

Arq Bras Endocrinol Metabol. 2011 Oct;55(7):486-9. doi: 10.1590/s0004-27302011000700009.

Abstract

Amiodarone (AM)-induced thyrotoxicosis (AIT) is a condition with uncertainties from the diagnostic and therapeutic standpoints. A 54-year old male was referred to the hospital due to thyrotoxicosis. He had history of atrial fibrillation medicated with AM. No history of pre-existing thyroid disease was present, thyroid palpation revealed no goiter, and there were no signs of Graves' ophthalmopathy. Thyroid autoantibodies and thyroid-stimulating hormone receptor antibodies (TRABs) were negative. Thyroid and Doppler ultrasounds were normal. 99mTc-sestaMIBI thyroid scan (STS) showed uptake with rapid washout. AM therapy was discontinued, and combined therapy was started. After a long course of glucocorticoid and thionamides, the patient became euthyroid. It is necessary to distinguish between the types of AIT to decide whether or not continue AM treatment; after that, the appropriate therapy should be selected. STS was very important in the diagnosis of the type of AIT.

Publication types

  • Case Reports

MeSH terms

  • Amiodarone / adverse effects*
  • Anti-Arrhythmia Agents / adverse effects*
  • Atrial Fibrillation / drug therapy
  • Diagnosis, Differential
  • Humans
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Technetium Tc 99m Sestamibi*
  • Thyrotoxicosis / chemically induced
  • Thyrotoxicosis / diagnostic imaging*
  • Thyrotoxicosis / drug therapy
  • Time Factors

Substances

  • Anti-Arrhythmia Agents
  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi
  • Amiodarone