Jod-Basedow Phenomenon Precipitating Diabetic Ketoacidosis: A Case Report

Jod-Basedow phenomenon (JBP) is an alternative term for iodine-induced thyrotoxicosis, which is a rare hyperthyroid illness that is brought on by excessive iodine exposure. Patients with underlying thyroid conditions, autoimmune diseases, or chronic renal disease are populations frequently affected by the JBP. The potential for this disorder to circumvent normal thyroid autoregulation and result in potentially fatal consequences makes it especially worrying. Here, we describe the case of a 50-year-old woman who had a known case of dyslipidemia, cardiomyopathy, and type 2 diabetes and presented to the emergency department with complaints of nausea and stomach pain. Diabetic ketoacidosis (DKA) was suspected based on venous blood gas reports that showed significant anion gap metabolic acidosis. Imaging revealed characteristics indicative of thyroiditis, and additional testing verified hyperthyroidism. Interestingly, the patient had only had iodinated contrast medium coronary angiography one day before presentation to the emergency department. This case highlights the underdiagnosed yet severe risk of iodine-induced thyroid dysfunction, particularly in patients with silent thyroid disease, which can precipitate acute conditions such as DKA.