Iodinated Contrast Media-Induced Thyroid Dysfunction in Euthyroid Nodular Goiter Patients.

Area of Science:

• Endocrinology
• Radiology
• Public Health

Background:

• The risk of thyroid dysfunction following iodinated contrast media (ICM) administration in patients with euthyroid nodular goiter (ENG) remains largely uncharacterized.
• ENG is a common condition, and ICM is frequently used in diagnostic imaging.

Purpose of the Study:

• To investigate the association between ICM exposure and the subsequent development of thyroid dysfunction in patients with ENG.
• To quantify the risk of hyperthyroidism and hypothyroidism in this patient population.

Main Methods:

• An observational, retrospective cohort study utilizing a random selection of one million individuals from Taiwan.
• Cases were patients with ENG exposed to ICM; controls were individuals without thyroid nodules exposed to ICM.
• Follow-up was conducted to identify the first event of thyroid dysfunction (hyperthyroidism or hypothyroidism) post-ICM exposure.

Main Results:

• The study included 334 ENG cases and 2672 matched controls.
• Patients with ENG exhibited a significantly higher risk of thyroid dysfunction (adjusted hazard ratio 5.43) compared to controls.
• Subgroup analyses revealed elevated risks for hyperthyroidism (HR 5.77) and hypothyroidism (HR 4.95) in the ENG group. Half of the ENG cases developed thyroid dysfunction within one year.

Conclusions:

• Euthyroid nodular goiter is a significant risk factor for developing thyroid dysfunction after iodinated contrast media exposure.
• The findings highlight the need for careful consideration and potential monitoring in patients with ENG undergoing procedures involving ICM.