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Iodine-induced hyperthyroidism due to nonionic contrast radiography in the elderly
F I Martin1, B W Tress, P G Colman
1Northwest Hospital, Melbourne, Australia.
The American Journal of Medicine
|July 1, 1993
Summary
Contrast radiography can trigger hyperthyroidism in elderly patients, with 25% of cases developing the condition after exposure. While often self-limiting, this iodine-induced thyrotoxicosis requires careful management in older adults.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Radiology
Background:
- Contrast radiography is a common diagnostic tool, particularly in the elderly.
- Iodine-containing contrast media can precipitate thyroid dysfunction in susceptible individuals.
- Elderly patients may have a higher prevalence of underlying thyroid autonomy.
Purpose of the Study:
- To determine the incidence of hyperthyroidism following contrast radiography in elderly patients.
- To describe the clinical course and management of contrast-induced hyperthyroidism in this population.
Main Methods:
- Retrospective identification of elderly patients with biochemical hyperthyroidism over 20 months.
- Assessment for exposure to nonionic contrast media radiographs within 12 months prior.
- Clinical evaluation and follow-up for 6 to 22 months.
Main Results:
- Seven of 28 hyperthyroid patients (25%) developed thyrotoxicosis post-contrast radiography.
- The condition typically manifested 3-8 weeks after exposure and was often associated with multinodular thyroid glands.
- While generally self-limiting, hyperthyroidism adversely affected patient recovery, with four patients responding to antithyroid medication.
Conclusions:
- Iodine-induced thyrotoxicosis is a significant complication of contrast radiography in the elderly, occurring in 25% of hyperthyroid cases studied.
- The prevalence is linked to autonomous thyroid nodules, common in this age group.
- Recognition and management are crucial due to the increasing use of contrast media in older adults.
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