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[Subtotal thyroid gland resection as therapy for thyrotoxic crises].

A Frilling¹, P E Goretzki, F A Horster

¹Abteilung für Allgemeine und Unfallchirurgie, Universität Düsseldorf.

Deutsche Medizinische Wochenschrift (1946)

|May 11, 1990

Summary

Iodine-induced thyrotoxic crises can occur in susceptible individuals. Subtotal thyroidectomy effectively treated five out of six patients experiencing these severe hyperthyroid events.

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Area of Science:

Endocrinology
Cardiology

Background:

Iodine-containing contrast media and amiodarone are known potential triggers for thyroid dysfunction.
Thyrotoxic crisis, a severe manifestation of hyperthyroidism, presents with significant systemic complications.

Observation:

Six patients (four female, two male) developed thyrotoxic crises.
Four crises were linked to iodine contrast media, one to amiodarone, and one had an uncertain trigger.
Patients exhibited elevated triiodothyronine (T3) and thyroxine (T4) levels, with symptoms including tachycardia, hypertension, dehydration, tremor, and altered mental status.

Findings:

Conservative treatment was ineffective in most cases.
Five patients underwent subtotal thyroidectomy, resulting in prompt relief of hyperthyroid symptoms and an uneventful recovery.

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One elderly patient with cardiac comorbidities was deemed unfit for surgery and ultimately died from refractory left ventricular failure.

Implications:

Subtotal thyroidectomy is a highly effective treatment for iodine-induced thyrotoxic crisis when conservative measures fail.
Early surgical intervention should be considered in patients with thyrotoxic crisis, balancing surgical risk with potential benefits.
Careful monitoring and management are crucial for patients at risk of iodine-induced thyroid dysfunction, particularly those with pre-existing cardiac conditions.