Amiodarone induced thyroid changes Histopath: Remarkably enlarged follicles, distended with colloid, without scalloping, and lined by flattened follicular cells. Some follicles contain numerous foamy macrophages representing destructive change, Follicular cells cytoplasm can be vacuolated containing yellowish pigment (lipofuscin) AIT develops in 3% of amiodarone-treated patients in North America For those living in iodine-depleted areas, the incidence is higher (10%) This risk also increases with increased dosage The thyrotoxicosis is mediated by amiodarone's iodine content. There are two types of AIT, type l and II, which can be distinguished based on history and pertechnetate scanning Weigh risks vs. benefits when determining cessation of amiodarone. Alternatives exist if patients do not respond to initial treatment Thyroidectomy is a reasonable definitive cure, especially if patients have cardiac conditions where they need to remain on amiodarone - Dr. Zubair Baloch @aakasharmand #Amiodarone #thyroid #thyrotoxicosis #AIT #Pathology #Clinical #Microscopy
