Case Report: A Patient with Atrial Fibrillation, Functional Class III Heart Failure, and Persistent Diarrhea

Aim: to demonstrate the directions of differential diagnosis of diarrheal syndrome in a polymorbid patient.

Key points. Diarrhea is one of the most common syndromes found in the practice of a clinician. Known pathophysiological mechanisms of diarrhea more often cover diseases that are familiar for diagnosis by gastroenterologists and infectious diseases specialists. Severe thyroid dysfunction can manifest itself as diarrhea syndrome. This article presents a clinical case of a 67-year-old male patient with severe amiodarone-induced thyrotoxicosis type 2 (with the development of thyrotoxic protein-losing enteropathy and thyrotoxic heart). The first-line drug of pharmacotherapy for this condition, prednisolone, had a timely positive effect. The patient is currently under the supervision of an endocrinologist and a cardiologist.

Conclusion. The presented clinical case shows the need to include thyrotoxicosis in the differential diagnostic search for the causes of diarrhea syndrome in an elderly patient, recalls the need to control the level of thyroid hormones and adjust the dose of amiodarone, considering polymorbidity and possible drug interactions.

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