Iodinated glycerol and thyroid dysfunction. Four cases and a review of the literature

Iodinated glycerol (Organidin) has recently been shown to be a useful adjunct in the symptomatic treatment of patients with chronic obstructive pulmonary disease (COPD). Over an 18-month period, we saw four patients with significant thyroid dysfunction resulting from iodinated glycerol use. All were elderly patients with COPD who had been started on standard doses of iodinated glycerol 4 to 24 months earlier. None of the patients had histories of thyroid disease. Three of the patients had symptomatic thyrotoxicosis and one had severe hypothyroidism while taking iodinated glycerol. We review the literature on the mechanisms and management of iodine-induced thyroid dysfunction and conclude the following: (1) all iodine-containing drugs may adversely affect thyroid function; (2) these compounds should be prescribed with extreme caution to any patients with underlying thyroid disease; and (3) all patients receiving iodine-containing medications should be closely monitored for evidence of thyroid dysfunction.