PT  - JOURNAL ARTICLE
AU  - Aisha Rummaan
AU  - Maryam Maryam
AU  - Awais Ali
AU  - Snigdhendu Mandal
AU  - Tamar Saeed
TI  - Resistant type 2 amiodarone-induced thyrotoxicosis responsive to cholestyramine as an adjunctive therapy
AID  - 10.7861/clinmed.2021-0482
DP  - 2021 Sep 01
TA  - Clinical Medicine
PG  - e529--e530
VI  - 21
IP  - 5
4099  - http://www.rcpjournals.org/content/21/5/e529.short
4100  - http://www.rcpjournals.org/content/21/5/e529.full
SO  - Clin Med2021 Sep 01; 21
AB  - Amiodarone is a class 3 antiarrhythmic drug which may be associated with thyroid dysfunction. Amiodarone-induced thyrotoxicosis (AIT) is classified as type 1 (AIT 1; which may develop in the presence of latent autoimmune hyperthyroid condition) or type 2 (AIT 2; which develops in an apparently normal thyroid resulting from destructive thyroiditis). AIT 1 routinely requires treatment with thionamides, whereas AIT 2 is treated with steroids. Resistance to the conventional treatment of hyperthyroidism is not commonly found in clinical practice. This report discusses a case of AIT 2 resistant to conventional treatment. Despite being on high doses of carbimazole and steroids (prednisolone), the patient remained thyrotoxic. Cholestyramine, a bile salt sequestrant, was used as an adjunctive therapy resulting in significant clinical and biochemical improvement. The patient subsequently became euthyroid and is being followed up in endocrine clinic.