Related Experiment Videos
Reversible primary hypothyroidism and elevated serum iodine level in patients with renal dysfunction
K Sato1, K Okamura, M Yoshinari
1Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Acta Endocrinologica
|March 1, 1992
Summary
Renal dysfunction may cause reversible hypothyroidism through impaired iodine handling, leading to a prolonged Wolff-Chaikoff effect. Thyroid function often recovers after iodine restriction in these patients.
Area of Science:
- Endocrinology
- Nephrology
Background:
- Thyroid dysfunction is common in patients with renal impairment.
- The pathogenesis of hypothyroidism in renal dysfunction is not fully understood.
Purpose of the Study:
- To investigate the role of iodine metabolism in the development of reversible hypothyroidism in patients with renal dysfunction.
Main Methods:
- Studied 36 patients with primary hypothyroidism and renal dysfunction.
- Assessed thyroid function recovery after iodine restriction.
- Measured serum iodine levels, thyroidal radioactive iodine uptake, and performed perchlorate discharge tests.
- Evaluated urinary iodine excretion in euthyroid patients with renal dysfunction.
Main Results:
- 83% of patients with hypothyroidism and renal dysfunction showed thyroid function recovery after iodine restriction.
- Elevated serum non-hormonal iodine and high thyroidal radioactive iodine uptake were observed.
- Evidence suggested an iodide organification defect, with negative antithyroid antibodies in most patients.
- Impaired urinary iodine excretion was noted in euthyroid patients with renal dysfunction.
Conclusions:
- Impaired renal iodine handling, not autoimmune mechanisms, likely causes reversible hypothyroidism in renal dysfunction.
- A prolonged Wolff-Chaikoff effect is implicated in the pathogenesis.
- Findings highlight the importance of iodine metabolism in thyroid function during renal impairment.