TY - JOUR T1 - Resistant type 2 amiodarone-induced thyrotoxicosis responsive to cholestyramine as an adjunctive therapy JF - Clinical Medicine JO - Clin Med SP - e529 LP - e530 DO - 10.7861/clinmed.2021-0482 VL - 21 IS - 5 AU - Aisha Rummaan AU - Maryam Maryam AU - Awais Ali AU - Snigdhendu Mandal AU - Tamar Saeed Y1 - 2021/09/01 UR - http://www.rcpjournals.org/content/21/5/e529.abstract N2 - 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. ER -