{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:30:30Z","timestamp":1788190230037,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2004,10,14]],"date-time":"2004-10-14T00:00:00Z","timestamp":1097712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2004,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Amiodarone\u2010associated thyrotoxicosis (AAT) is often poorly tolerated owing to underlying cardiac disease, and it is frequently refractory to conventional medical treatment. The goal of this study was to describe the patient characteristics, management, and outcomes of all the patients treated surgically for AAT at a single institution. We conducted a retrospective chart review of all patients managed surgically for AAT (April 1985 through November 2002) at the Mayo Clinic in Rochester, Minnesota. Altogether, 29\u00a0men and 5 women, ages 39 to 85 years (median 60 years), treated with amiodarone for 3 to 108\u00a0months underwent near\u2010total or total thyroidectomy. Frequent symptoms were worsening heart failure, fatigue, weight loss, and tremor. Altogether, 12 patients failed medical management of their AAT, and 21 received no preoperative medical therapy. One patient had been successfully managed medically but required definitive treatment. Common indications for operation were the need to remain on amiodarone, cardiac decompensation, medically refractory disease, and severe symptoms, both hyperthyroid and cardiac, necessitating prompt resolution. The median \u00b1 SD American Society of Anesthesiologists (ASA) classification (1 = healthy through 5 = moribund) was 3.00 \u00b1 0.58. A total of 27 specimens had histology consistent with AAT. Complications included death (<jats:italic>n<\/jats:italic> = 3), rehospitalization (<jats:italic>n<\/jats:italic> = 3), symptomatic hypocalcemia (<jats:italic>n<\/jats:italic> = 2), pneumonia (<jats:italic>n<\/jats:italic> = 2), cervical hematoma (<jats:italic>n<\/jats:italic> = 1), prolonged ventilatory wean (<jats:italic>n<\/jats:italic> = 1), and stroke (<jats:italic>n<\/jats:italic> = 1); one patient developed hypotension, adult respiratory distress syndrome, and sepsis. Of the 31 surviving patients, 25 (80%) remained on amiodarone postoperatively. The median follow\u2010up was 29\u00a0months, at which time all surviving patients were free of hyperthyroid symptoms. Thyroidectomy is an effective treatment for AAT but has a high incidence of perioperative morbidity and mortality. The cardiovascular co\u2010morbidities and high operative risk in this group of patients may account for the increased complication rate.<\/jats:p>","DOI":"10.1007\/s00268-004-7599-6","type":"journal-article","created":{"date-parts":[[2004,10,14]],"date-time":"2004-10-14T21:23:41Z","timestamp":1097789021000},"page":"1083-1087","source":"Crossref","is-referenced-by-count":83,"title":["Surgical Management of Amiodarone\u2010associated Thyrotoxicosis: Mayo Clinic Experience"],"prefix":"10.1002","volume":"28","author":[{"given":"Scott G.","family":"Houghton","sequence":"first","affiliation":[{"name":"Department of Surgery Mayo Clinic and Mayo Foundation 200 First Street SW 55905 Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Farley","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic and Mayo Foundation 200 First Street SW 55905 Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Mayo Clinic and Mayo Foundation 200 First Street SW 55905 Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon A.","family":"van Heerden","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic and Mayo Foundation 200 First Street SW 55905 Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey B.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic and Mayo Foundation 200 First Street SW 55905 Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive S.","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic and Mayo Foundation 200 First Street SW 55905 Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,14]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"1062","article-title":"Amiodarone\u2010associated thyrotoxicosis (AAT): experience with surgical management","volume":"102","author":"Brennan MD","year":"1987","journal-title":"Surgery"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(84)80367-8"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-62-3-563"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.1.3"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1995.5.177"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.10.4707"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440\u20101622.2000.01780.x"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03440110092034"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00024613"},{"key":"e_1_2_8_11_2","first-page":"1114","article-title":"Amiodarone\u2010induced thyrotoxicosis: clinical presentation and expanded indications for thyroidectomy","volume":"114","author":"Mulligan DC","year":"1993","journal-title":"Surgery"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0033\u20100620(89)90017\u20100"},{"key":"e_1_2_8_13_2","first-page":"1","article-title":"Amiodarone and the thyroid","volume":"13","author":"Lombardi A","year":"1990","journal-title":"Thyroid Today"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1987.tb00781.x"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.22.2.240"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.79.2.121"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.81.8.2930"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0300\u20100664.2001.01457.x"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.105.11.1275"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03348098"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6687.1547"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2002.128561"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.4.389"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010002\u20106426\u20101"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-004-7599-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-004-7599-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-004-7599-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,24]],"date-time":"2023-12-24T11:35:18Z","timestamp":1703417718000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-004-7599-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,10,14]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2004,11]]}},"alternative-id":["10.1007\/s00268-004-7599-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-004-7599-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,10,14]]}}}