{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T16:39:46Z","timestamp":1779295186244,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2004,9,16]],"date-time":"2004-09-16T00:00:00Z","timestamp":1095292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold><jats:sc>objective\u2002<\/jats:sc><\/jats:bold> To determine how expert European thyroidologists assess and treat amiodarone\u2010induced thyrotoxicosis (AIT).<\/jats:p><jats:p><jats:bold><jats:sc>design\u2002<\/jats:sc><\/jats:bold> Members of the European Thyroid Association (ETA) with clinical interests were asked to answer a questionnaire on the diagnosis and management of AIT. A total of 124 responses were received: 116 from Europe, seven from USA and one from Brazil. After excluding responses coming from the same centre, 101 responses from 24 European countries were analysed, representing approximately 65% of clinically active European ETA members.<\/jats:p><jats:p><jats:bold><jats:sc>results\u2002<\/jats:sc><\/jats:bold> The majority of respondents (68%) see 1\u201310 new cases of AIT\/year, and AIT seems to be more frequent than amiodarone\u2010induced hypothyroidism in Europe, where in many instances iodine intake is borderline or moderately deficient. A good collaboration with cardiologists exists in most centres, and patients receiving chronic amiodarone treatment are checked for thyroid function most commonly every 4\u20136\u00a0months. When AIT is suspected, a diffuse or nodular goitre is present or in the absence of apparent abnormalities of the thyroid, free thyroxine (FT4), free triiodothyronine (FT3) and TSH are assayed by almost 90% of respondents. Thyroid autoimmunity is evaluated in the initial assessment by &gt;\u00a080%, while evaluation of urinary iodine excretion is unhelpful for\u00a0&gt;\u00a060%. Most commonly used additional diagnostic procedures include thyroid ultrasonography, particularly colour flow Doppler sonography, and, to a lesser extent, a thyroid uptake scan. If the thyroid gland is apparently normal, measurement of thyroidal radioactive iodine uptake is considered useful by a large proportion of respondents to establish the destructive nature of the process. Differentiation of type I and type II AIT is difficult and, possibly, not correct for 27% of respondents, who believe that mixed (or indefinite) forms are probably more frequent than previously recognized. Approximately 10\u201320% do not consider amiodarone withdrawal necessary in the therapeutic strategy of AIT, especially if the thyroid gland is apparently normal. Most respondents (82%) treat type I AIT with thionamides, either alone (51%) or in combination with potassium perchlorate (31%), while the preferred treatment for type II AIT is represented by glucocorticoids (46%). Some respondents, in view of diagnostic difficulties, initially treat all cases of AIT with a combination of thionamides and glucocorticoids. After restoration of euthyroidism, ablative therapy is recommended by 34% in type I and only 8% in type II AIT. If amiodarone therapy needs to be reinstituted, prophylactic thyroid ablation is recommended by 65% in type I AIT, while a wait\u2010and\u2010see strategy is adopted by 70% in type II AIT.<\/jats:p><jats:p><jats:bold><jats:sc>conclusion\u2002<\/jats:sc><\/jats:bold> Areas of certainty and uncertainty concerning AIT are present among expert European thyroidologists, both from a diagnostic and a therapeutic standpoint. Diagnostic criteria need to be refined in order to improve therapeutic outcome.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2004.02119.x","type":"journal-article","created":{"date-parts":[[2004,10,7]],"date-time":"2004-10-07T10:39:38Z","timestamp":1097145578000},"page":"494-502","source":"Crossref","is-referenced-by-count":66,"title":["Diagnosis and management of amiodarone\u2010induced thyrotoxicosis in Europe: results of an international survey among members of the European Thyroid Association"],"prefix":"10.1111","volume":"61","author":[{"given":"Luigi","family":"Bartalena","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilmar M.","family":"Wiersinga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria 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