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Thyrotoxicosis induced by topical iodine application.

K R Shetty1, E H Duthie

  • 1Section of Geriatrics and Gerontology, Zablocki Veterans Administration Medical Center, Milwaukee.

Archives of Internal Medicine
|November 1, 1990
PubMed
Summary
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Elderly patients with thyroid disorders should be monitored when using povidone-iodine (Betadine) soaks for pressure sores. Topical iodine can unmask latent Graves' disease, leading to thyrotoxicosis.

Area of Science:

  • Endocrinology
  • Dermatology

Background:

  • Congestive cardiac failure and thyrotoxicosis can present similarly in elderly patients.
  • Thyrotoxicosis is often associated with goiter and elevated radioiodine uptake.

Observation:

  • An elderly male patient presented with congestive cardiac failure and was diagnosed with thyrotoxicosis.
  • He exhibited normal radioiodine uptake and no goiter, but had elevated serum iodine levels.
  • The patient's pressure sores were treated with povidone-iodine (Betadine) soaks.

Findings:

  • Biochemical data indicated Graves' disease, unmasked by topical iodine application.
  • Elevated serum iodine levels explained the suppressed radioiodine uptake.
  • Povidone-iodine soaks are a potential trigger for iodine-induced thyrotoxicosis.

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Implications:

  • Povidone-iodine soaks are commonly used for decubitus ulcer care and require caution in patients with thyroid conditions.
  • Healthcare providers should consider topical iodine exposure when evaluating thyrotoxicosis in susceptible patients.
  • This case highlights an unusual complication of a common dermatological treatment in patients with underlying thyroid disease.