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Effect of high-dose intravenous glucocorticoid therapy on serum thyroid hormone concentrations in type 2 amiodarone-induced thyrotoxicosis: an exploratory study
- Publication Year :
- 2020
-
Abstract
- Type 2 amiodarone-induced thyrotoxicosis (AIT2) is a form of drug-induced destructive thyroiditis, usually treated with oral glucocorticoids (oGCs). Our objective was to investigate the short-term effects of intravenous glucocorticoids (ivGCs) on serum thyroid hormone concentrations in patients with AIT2. Exploratory study of three naive AIT2 patients treated with iv methylprednisolone (two pulses of 400 mg with no interpulse oGCs), followed by oGCs, matched 1:3 with AIT2 patients treated with oGCs alone. Changes in serum thyroid hormone concentrations were evaluated in the short-term period (24 h and 7 days) and after a cumulative dosage of 400 and 800 mg equivalents of methylprednisolone; in addition, healing time and duration of exposure to GCs were calculated. During the first 24 h of treatment, serum FT4 concentrations increased in ivGCs patients, and decreased in oGCs patients (+ 3.3% vs − 10.7%, respectively, p = 0.025). After 7 days, serum FT4 and FT3 concentrations decreased significantly in both groups, with no statistical difference between them (p = 0.439 for FT4 and p = 0.071 for FT3), even though the cumulative GCs dose was higher in ivGCs than in oGCs patients (800 mg vs 280 mg, p = 0.008). Furthermore, the iv administration of single 400 mg pulses of methylprednisolone resulted in a less significant decrease in serum thyroid hormone concentrations when compared to equivalent GCs doses fractionated in several consecutive days (p = 0.021 for FT4 and p = 0.052 for FT3). There were no significant differences in the healing time (p = 0.239) and duration of exposure to GCs (p = 0.099). High-dose ivGCs therapy does not offer advantages over standard oGCs therapy in the rapid, short-term control of AIT2.
- Subjects :
- Adult
Male
Thyroid Hormones
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Statistical difference
Amiodarone
Pilot Projects
030209 endocrinology & metabolism
AIT
Corticosteroids
Glucocorticoids
Thyrotoxicosis
Methylprednisolone
Gastroenterology
Amiodarone-induced thyrotoxicosis
Thyroiditis
03 medical and health sciences
0302 clinical medicine
Endocrinology
Internal medicine
medicine
Humans
Aged
Dose-Response Relationship, Drug
business.industry
Thyroid
Middle Aged
medicine.disease
medicine.anatomical_structure
Glucocorticoid therapy
030220 oncology & carcinogenesis
Administration, Intravenous
Female
business
hormones, hormone substitutes, and hormone antagonists
medicine.drug
Hormone
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....6f460770b444b22992e59a2cfdd5e2f8