Iodinated contrast and hyperthyroidism
Author:
Mikael Häggström [notes 1]
Risk factors
Iodinated contrast can cause thyrotoxicosis in people with hyperthyroid diseases, mainly toxic multinodular goiter, Graves’ disease, or Hashimoto’s thyroiditis.[1] Otherwise, for the general population, routine screening with thyroid function tests is generally not feasible.[1]
Management
| Risk | Example situations | Main alternatives |
|---|---|---|
| Low risk |
|
|
| High risk |
|
|
Monitoring
Notify the referring physician, or the patient's family physician, or possibly put responsibility over to the patient to do this. The hyperthyroidism usually develops over 2 to 12 weeks following iodine administration.[2] Patients who develop symptoms may be treated with a β-blocker and/or methimazole.[3]
Thyrostatic
Thyrostatic medication may consist of:
- Perchlorate (sodium or potassium perchlorate), 200 mg twice or three times daily[3]
- Thiamazole, 20 mg/d[3]
It can be started on the day of the exam, and continued for 14 days,[3] and may thereafter be followed by monitoring.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
- ↑ Making the patient more susceptible to the effects of hyperthyroidism, if it occurs.
References
- ↑ 1.0 1.1 Yıldız, Sema; Kuşkonmaz, Şerife Mehlika (2016). "Effect of iodinated contrast media on thyroid: a brief review ". Journal of Health Sciences 6 (1): 12. doi:. ISSN 1986-8049.
- ↑ "Iodinated contrast-induced thyrotoxicosis. ". CMAJ 185 (2): 144-7. 2013. doi:. PMID 23148056. PMC: 3563887. Archived from the original. .
- ↑ 3.0 3.1 3.2 3.3 Lee, Sun Y.; Rhee, Connie M.; Leung, Angela M.; Braverman, Lewis E.; Brent, Gregory A.; Pearce, Elizabeth N. (2015). "A Review: Radiographic Iodinated Contrast Media-Induced Thyroid Dysfunction ". The Journal of Clinical Endocrinology & Metabolism 100 (2): 376–383. doi:. ISSN 0021-972X.
