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Contrast induced hyperthyroidism due to iodine excess.

Usman Mushtaq1, Timothy Price, Narsing Laddipeerla

  • 1The Queen Elizabeth Hospital, Medicine, 28-Woodville Road, Woodville South, Adelaide, South Australia, 5011, Australia.

BMJ Case Reports
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Iodine induced hyperthyroidism, a condition from excessive iodine exposure, is increasingly seen due to medical treatments. Diagnosis and management are challenging, especially in elderly patients, due to atypical symptoms and treatment resistance.

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Area of Science:

  • Endocrinology
  • Thyroidology

Background:

  • Iodine induced hyperthyroidism is a thyrotoxic condition resulting from excessive iodine intake.
  • Historically documented in iodine-deficient regions, it is now increasingly observed due to medical interventions.
  • Iodinated contrast agents and medications like amiodarone are common sources of excess iodine.

Purpose of the Study:

  • To review the clinical presentation and management challenges of iodine induced hyperthyroidism.
  • To highlight the difficulties in diagnosing and treating this condition, particularly in elderly populations.
  • To discuss the implications of iatrogenic iodine exposure on thyroid function.

Main Methods:

  • Literature review of iodine induced hyperthyroidism.
  • Analysis of case studies involving amiodarone and radiological contrast agents.
  • Discussion of diagnostic criteria and therapeutic strategies.

Main Results:

  • Elderly patients often present with atypical symptoms, complicating diagnosis.
  • Contrast-induced hyperthyroidism can be difficult to manage due to resistance to standard therapies.
  • Excess iodine can lead to persistent thyrotoxicosis that is refractory to conventional treatment.

Conclusions:

  • Iodine induced hyperthyroidism poses a significant diagnostic and therapeutic challenge.
  • Increased awareness and careful monitoring are crucial for patients exposed to high iodine loads.
  • Novel treatment approaches may be necessary for managing this complex endocrine disorder.