Endocrine Abstracts

68 year old lady was on amiodarone for atrial fibrillation and poor left ventricular systolic function. She was feeling unwell, so she had some blood tests which showed elevated free T4 and suppressed TSH. She did not have a family history of thyroid disease. She did not have a goitre or eye signs. She did not have overt signs of thyrotoxicosis. She was admitted as her heart failure was not controlled and her diuretics were optimised. Her thyroid antibodieswere checked and was sent for a radioiodine uptake scan. The uptake was slightly reduced and thyroglobulin was normal. The vascularity was normal or slight increased. She was started on steroids with carbimazole. Amiodarone was stopped. Repeat thyroid function showed in 6 weeks a fall in free T4 and TSH started to improve. This case shows the difficulty to differentiate between AIT type 1 and 2. You may have to treat as both and decide later.