Differential diagnosis of amiodarone-induced thyrotoxicosis in a patient with atrial fibrillation and agranulocytosis on the background of thyrostatic therapy. Case report

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Abstract

Atrial fibrillation is the most common heart rhythm disorder in patients with chronic heart failure. One of the most effective antiarrhythmic drugs for the treatment and prevention of a wide range of supraventricular and ventricular tachyarrhythmia is amiodarone. In the group of patients with paroxysmal atrial fibrillation and low left ventricular ejection fraction, it is the drug of choice when conducting a „rhythm control“ strategy. Patients receiving amiodarone often develop an adverse event – amiodarone-induced thyrotoxicosis, which exacerbates the course of cardiovascular pathology. In this article, we consider a clinical case of amiodarone-induced thyrotoxicosis in a 30-year-old patient with dilated cardiomyopathy and agranulocytosis that developed against the background of thyrostatic therapy.

About the authors

Kristina Yu. Zherebchikova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: k.y.zherebchikova@gmail.com
ORCID iD: 0000-0003-0292-5907

Аssistant

Russian Federation, Moscow

Dmitry S. Bubnov

Myasnikov Research Institute of Clinical Cardiology, Chazov National Medical Research Center of Cardiology

Email: k.y.zherebchikova@gmail.com
ORCID iD: 0000-0003-1538-2761

Res. Assist.

Russian Federation, Moscow

Alexandra S. Ermolaeva

Sechenov First Moscow State Medical University (Sechenov University)

Email: k.y.zherebchikova@gmail.com
ORCID iD: 0000-0002-6471-8252

Endocrinologist

Russian Federation, Moscow

Madina O. Soltakhanova

Sechenov First Moscow State Medical University (Sechenov University)

Email: k.y.zherebchikova@gmail.com
ORCID iD: 0009-0004-2816-0943

Student

Russian Federation, Moscow

Yulia P. Sych

Sechenov First Moscow State Medical University (Sechenov University)

Email: k.y.zherebchikova@gmail.com
ORCID iD: 0000-0002-7000-0095

Cand. Sci. (Med.)

Russian Federation, Moscow

Marat V. Ezhov

Myasnikov Research Institute of Clinical Cardiology, Chazov National Medical Research Center of Cardiology

Email: k.y.zherebchikova@gmail.com
ORCID iD: 0000-0002-1518-6552

D. Sci. (Med.), Department Head

Russian Federation, Moscow

Valentin V. Fadeev

Sechenov First Moscow State Medical University (Sechenov University)

Email: k.y.zherebchikova@gmail.com
ORCID iD: 0000-0002-2504-7468

D. Sci. (Med.), Prof., Corr. Memb. RAS, Department Head

Russian Federation, Moscow

References

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2. Fig 1. Case history.

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3. Fig. 2. Ultrasound of the thyroid gland. The volume of the thyroid is not increased, decreased echogenicity of the parenchyma is observed.

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4. Fig. 3. Electrocardiograms before (a) and after (b) EIT in the patient: a - TP with atrial contraction rate 271 per minute and 2:1 ventricular conduction, ventricular contraction rate 144 per minute, full BLNPG; b - artificially rhythmic atrial-ventricular stimulation, heart rate 65 per minute.

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