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Iodine-induced thyrotoxicosis: analysis of eighty-five consecutive cases.

A F Leger, J P Massin, M F Laurent

    European Journal of Clinical Investigation
    |December 1, 1984
    PubMed
    Summary

    Iodine-induced thyrotoxicosis, often affecting normal thyroid glands, can be triggered by amiodarone. Recovery typically occurs within six months, sometimes preceded by temporary hypothyroidism.

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    Area of Science:

    • Endocrinology
    • Thyroidology
    • Pharmacology

    Background:

    • Iodine is essential for thyroid hormone synthesis but can paradoxically induce thyrotoxicosis.
    • Amiodarone is a known cause of iodine-induced thyrotoxicosis, particularly in individuals with pre-existing thyroid conditions or normal glands.
    • Understanding the clinical presentation and natural history of iodine-induced thyrotoxicosis is crucial for effective management.

    Purpose of the Study:

    • To document and analyze cases of iodine-induced thyrotoxicosis.
    • To investigate the characteristics of affected individuals, including thyroid gland status and gender distribution.
    • To evaluate the role of amiodarone and assess thyroid function, iodine uptake, and recovery patterns.

    Main Methods:

    • Retrospective analysis of eighty-five documented cases of iodine-induced thyrotoxicosis.

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  • Measurement of thyroid hormone levels (FT4, T3), radioactive iodine uptake (131I), and thyroid-stimulating hormone (TSH).
  • Assessment of intrathyroid iodine content using X-ray fluorescence and histological/electron microscopic examination of thyroid tissue.

    • Main Results:

    • Eighty percent of cases occurred in apparently normal thyroid glands, with 60% in males.
    • Amiodarone was responsible for 50% of cases; elevated FT4 and T3 levels were observed at diagnosis.
    • Low 131I uptake, responsive to TSH, was noted. Spontaneous cure averaged six months, often preceded by transient hypothyroidism. High intrathyroid iodine and thyroglobulin overiodination were confirmed.

    Conclusions:

    • Iodine-induced thyrotoxicosis frequently affects individuals with normal thyroid glands and is often linked to amiodarone use.
    • The condition typically resolves spontaneously within months, with a characteristic pattern of transient hypothyroidism during recovery.
    • Prednisone and propylthiouracil demonstrated efficacy in managing these cases.