Severe Amiodarone-Induced Thyrotoxicosis in 2 Patients Who Required Plasmapheresis Before Thyroidectomy

Amiodarone is a class III antiarrhythmic medication known for its complex interplay with thyroid physiology. Its prolonged half-life can result in persistent effects on thyroid function even after discontinuation. Amiodarone-induced thyrotoxicosis (AIT) is a serious and challenging complication due to these lasting effects. We present the cases of 2 patients who developed AIT resistant to standard medical treatment. Both patients required plasmapheresis sessions to reduce circulating levels of tetraiodothyronine (T4) prior to undergoing total thyroidectomy. Plasmapheresis is an effective intervention that significantly decreases circulating thyroid hormone levels, thereby lowering surgical risks associated with severe cardiac complications linked to thyrotoxicosis.