14-18% of amiodarone-treated patients, there is overt thyroid dysfunction, usually in the form of amiodarone-induced thyrotoxicosis, which can be difficult to manage with standard medical treatment.Case Presentation Presented is the case of a 65-year-old man, under chronic treatment of atrial fibrillation with amiodarone, who was admitted to the Intensive Care Unit with acute cardio-respiratory failure and fever.Recently hospitalized with respiratory distress, attributed to amiodarone-induced pulmonary fibrosis.And laboratory investigation revealed thyrotoxicosis due to amiodarone treatment.Begun on thionamide, prednisone and beta-blockers.A short term improvement of his clinical status the patient underwent percutaneous tracheotomy due to weaning failure from mechanical ventilation, which led to the development of recurrent thyrotoxicosis, unresponsive to medical treatment.The patient developed multiple organ failure and died, seven days later.Conclusions We suggest that percutaneous tracheotomy could precipitate a thyrotoxic crisis, particularly in non-euthyroid patients suffering from concurrent severe illness and should be performed only in parallel with emergency thyroid surgery, when indicated.Read more
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