Refractory Amiodarone-induced Thyrotoxicosis: The Surgical Option

Amiodarone-induced thyrotoxicosis is often poorly tolerated owing to underlying cardiac disease, and frequently resistant to medical therapy. We describe a 48-year-old patient with severe cardiac disease who developed amiodarone-associated thyrotoxicosis, refractory to standard medical therapy. Due to the unremitting thyrotoxicosis, a total thyroidectomy was performed without complications resulting in rapid correction of the thyrotoxicosis and enabling resumption of amiodarone therapy. Despite the concerns inherent to severe cardiac disease, total thyroidectomy can be performed safely in patients with resistant amiodarone-induced thyrotoxicosis. We believe that surgery should be considered early in the treatment planning.