Iodinated contrast media-induced hyperthyroidism
DOI:
https://doi.org/10.20883/medical.e439Keywords:
thyroid, iodine, hyperthyroidism, iodinated contrast media, iodine-induced hyperthyroidism, prophylactic therapyAbstract
Currently, iodinated contrast media (ICM) is widely used in radiology, therefore numerous patients are exposed to contrast administration during diagnostic and interventional procedures. ICM contains an amount of iodine well above the recommended dietary allowance, which can lead to thyroid dysfunction. Indeed, individuals that are highly susceptible to increased iodine intake are often patients with pre-existing thyroid disease. ICM-induced hyperthyroidism (IIH) is usually transient, however, it may present as clinically significant thyrotoxicosis. Although IIH has been investigated in multiple studies, there is still a lack of consensus regarding prophylactic therapy of IIH and no specific guidelines. This review aimed to summarise previous literature concerning the influence of ICM exposure on thyroid status and prophylactic therapy of IIH.
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Thomsen HS, Morcos SK, van der Molen AJ. Effect of iodinated contrast media on thyroid function in adults. European Radiology. 2004 May 1;14(5):902-907. https://doi.org/10.1007/s00330-004-2238-z
Rhee CM. Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism. Archives of Internal Medicine. 2012 Jan 23;172(2):153. https://doi.org/10.1001/archinternmed.2011.677
Thomsen HS. European Society of Urogenital Radiology (ESUR) guidelines on the safe use of iodinated contrast media. European Journal of Radiology. 2006 Dec;60(3):307-313. https://doi.org/10.1016/j.ejrad.2006.06.020
Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press; 2001. https://doi.org/10.17226/10026
Ortiga‐Carvalho TM, Chiamolera MI, Pazos‐Moura CC, Wondisford FE. Hypothalamus-Pituitary-Thyroid Axis. Compr Physiol. 2016;6(3):1387-428. https://doi.org/10.1002/cphy.c150027
Coscia F, Taler-Verčič A, Chang VT, Sinn L, O’Reilly FJ, Izoré T, Renko M, Berger I, Rappsilber J, Turk D, Löwe J. The structure of human thyroglobulin. Nature. 2020 Feb;578(7796):627-630. https://doi.org/10.1038/s41586-020-1995-4
Schimmel M. Thyroidal and Peripheral Production of Thyroid Hormones. Annals of Internal Medicine. 1977 Dec 1;87(6):760. https://doi.org/10.7326/0003-4819-87-6-760
Mansourian A. Metabolic Pathways of Tetraidothyronine and Triidothyronine Production by Thyroid Gland: A Review of Articles. Pakistan Journal of Biological Sciences. 2011 Jan 1;14(1):1-12. https://doi.org/10.3923/pjbs.2011.1.12
World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers, 3rd ed. https://apps.who.int/iris/handle/10665/43781. Accessed 2020 June.
Zimmermann MB. Iodine Deficiency. Endocrine Reviews. 2009 Jun;30(4):376-408. https://doi.org/10.1210/er.2009-0011
Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. The Lancet. 2008 Oct;372(9645):1251-1262. https://doi.org/10.1016/s0140-6736(08)61005-3
The Iodine Global Network. Global scorecard of iodine nutrition in 2019 in the general population based on school-age children (SAC). https://www.ign.org/cm_data/Global_Scorecard_2019_SAC.pdf. Accessed 2020 June.
Szybiński Z, Polish Council for Control of Iodine Deficiency Disorders. Work of the Polish Council for Control of Iodine Deficiency Disorders, and the model of iodine prophylaxis in Poland. Endokrynol Pol. 2012;63(2):156-60. PMID 22538756
Iodine status worldwide. WHO Global Database on Iodine Deficiency. 2004. https://apps.who.int/iris/bitstream/handle/10665/43010/9241592001.pdf?sequence=1. Accessed 2020 June.
Zimmermann MB, Galetti V. Iodine intake as a risk factor for thyroid cancer: a comprehensive review of animal and human studies. Thyroid Research. 2015 Jun 18;8(1). https://doi.org/10.1186/s13044-015-0020-8
Paul T, Meyers B, Witorsch R, Pino S, Chipkin S, Ingbar S, Braverman L. The effect of small increases in dietary iodine on thyroid function in euthyroid subjects. Metabolism. 1988 Feb;37(2):121-124. https://doi.org/10.1016/s0026-0495(98)90004-x
Gardner D, Centor R, Utiger R. Effects of Low Dose Oral Iodide Supplementation on Thyroid Function in Normal Men. Clinical Endocrinology. 1988 Mar;28(3):283-288. https://doi.org/10.1111/j.1365-2265.1988.tb01214.x
Scientific Committee on Food. Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Iodine (expressed on 26 September 2002). https://ec.europa.eu/food/sites/food/files/safety/docs/sci-com_scf_out146_en.pdf. Accessed 2020 June.
Expert Group on Vitamins and Minerals. Safe Upper Levels for Vitamins and Minerals. May 2003. https://cot.food.gov.uk/sites/default/files/vitmin2003.pdf. Accessed 2020 June.
Council for Responsible Nutrition. Vitamin and Mineral Safety 3rd Edition. 2014. https://www.crnusa.org/sites/default/files/files/resources/CRN-SafetyBook-3rdEdition-2014-fullbook.pdf. Accessed 2020 June.
Leung AM, Avram AM, Brenner AV, Duntas LH, Ehrenkranz J, Hennessey JV, Lee SL, Pearce EN, Roman SA, Stagnaro-Green A, Sturgis EM, Sundaram K, Thomas MJ, Wexler JA. Potential Risks of Excess Iodine Ingestion and Exposure: Statement by the American Thyroid Association Public Health Committee. Thyroid. 2015 Feb;25(2):145-146. https://doi.org/10.1089/thy.2014.0331
Leung AM, Braverman LE. Consequences of excess iodine. Nature Reviews Endocrinology. 2013 Dec 17;10(3):136-142. https://doi.org/10.1038/nrendo.2013.251
Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels M, Sosa JA, Stan MN, Walter MA. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421. https://doi.org/10.1089/thy.2016.0229
Biban BG, Lichiardopol C. Iodine Deficiency, Still a Global Problem?. Current Health Sciences Journal. 2017 Jul 31;(2):103-111. https://doi.org/10.12865/CHSJ.43.02.01
Vagenakis AG, Wang C, Burger A, Maloof F, Braverman LE, Ingbar SH. Iodide-Induced Thyrotoxicosis in Boston. New England Journal of Medicine. 1972 Sep 14;287(11):523-527. https://doi.org/10.1056/nejm197209142871101
ESUR Contrast Media Safety Committee. ESUR Guidlines on Contrast Media. http://www.esur.org/guidelines/en/index.php#a. Accessed 2020 June.
Thomsen H, Bellin M, Jakobsen J, Webb J. Contrast Media Classification and Terminology. In: Thomsen H, Webb JAW, eds. Contrast Media Safety Issues and ESUR Guidelines. Berlin, Heidelberg: Springer Berlin Heidelberg; 2014:3-11.
Isola S, Furci F, Gangemi S. The involvement of osmolarity in the safety of contrast media. Clinical and Molecular Allergy. 2018 Sep 3;16(1). https://doi.org/10.1186/s12948-018-0097-4
Mujtaba F, Saghir T, Sial J, Nasseb K, Karim M. Evaluation of Contrast Amount in Patients Undergoing Cardiac Catheterization for Diagnostic and Therapeutic Procedures. EC CARDIOLOGY. 2019;6(2):102-8.
Lee SY, Chang DL, He X, Pearce EN, Braverman LE, Leung AM. Urinary Iodine Excretion and Serum Thyroid Function in Adults After Iodinated Contrast Administration. Thyroid. 2015 May;25(5):471-477. https://doi.org/10.1089/thy.2015.0024
Fradkin JE, Wolff J. Iodide-Induced Thyrotoxicosis. Medicine. 1983 Jan;62(1):1-20. https://doi.org/10.1097/00005792-198301000-00001
Roti E, Uberti ED. Iodine Excess and Hyperthyroidism. Thyroid. 2001 May;11(5):493-500. https://doi.org/10.1089/105072501300176453
Skórkowska-Telichowska K, Kosińska J, Szymczak R, Tuchendler D, Tuchendler R, Telichowski A, Szajn G, Bolanowski M. Comparison and assessment of thyroid morphology and function in inhabitants of Lower Silesia before and after administration of a single dose of iodine-containing contrast agent during cardiac intervention procedure. Endokrynol Pol. 2012;63(4):294-9.
Ozkan S, Oysu AS, Kayatas K, Demirtunç R, Eren M, Uslu H, Altuntas Y. Thyroid functions after contrast agent administration for coronary angiography: a prospective observational study in euthyroid patients. Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology. 2013 Apr 24;. https://doi.org/10.5152/akd.2013.134
Koroscil, MD, PhD TM, Pelletier, MD PR, Slauson, MD JW, Hennessey, MD J. Short-term effects of coronary angiographic contrast agents on thyroid function. Endocrine Practice. 1997 Jul;3(4):219-221. https://doi.org/10.4158/ep.3.4.219
Kaneshige T, Arata N, Harada S, Ohashi T, Sato S, Umehara N, Saito T, Saito H, Murashima A, Sago H. Changes in Serum Iodine Concentration, Urinary Iodine Excretion and Thyroid Function After Hysterosalpingography Using an Oil-Soluble Iodinated Contrast Medium (Lipiodol). The Journal of Clinical Endocrinology & Metabolism. 2015 Mar;100(3):E469-E472. https://doi.org/10.1210/jc.2014-2731
Jarvis C, Simcox K, Tamatea JAU, McAnulty K, Meyer-Rochow GY, Conaglen JV, Elston MS. A low incidence of iodine-induced hyperthyroidism following administration of iodinated contrast in an iodine-deficient region. Clinical Endocrinology. 2015 Jun 19;84(4):558-563. https://doi.org/10.1111/cen.12818
Hintze G, Blombach O, Fink H, Burkhardt U, Kobberling J. Risk of iodine-induced thyrotoxicosis after coronary angiography: an investigation in 788 unselected subjects. European Journal of Endocrinology. 1999 Mar 1;:264-267. https://doi.org/10.1530/eje.0.1400264
Bonelli N, Rossetto R, Castagno D, Anselmino M, Vignolo F, Parasiliti Caprino M, Gaita F, Ghigo E, Garberoglio R, Grimaldi R, Maccario M. Hyperthyroidism in patients with ischaemic heart disease after iodine load induced by coronary angiography: Long-term follow-up and influence of baseline thyroid functional status. Clinical Endocrinology. 2017 Nov 20;88(2):272-278. https://doi.org/10.1111/cen.13494
Conn JJ, Sebastian MJ, Deam D, Tam M, Martin F. A Prospective Study of the Effect of Nonionic Contrast Media on Thyroid Function. Thyroid. 1996 Apr;6(2):107-110. https://doi.org/10.1089/thy.1996.6.107
Windecker S, Kolh P, Alfonso F, Collet J, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann F, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A. 2014 ESC/EACTS Guidelines on myocardial revascularization. EuroIntervention. 2015 Jan;10(9):1024-1094. https://doi.org/10.4244/eijy14m09_01
Alkhuja S, Pyram R, Odeyemi O. In the eye of the storm: Iodinated contrast medium induced thyroid storm presenting as cardiopulmonary arrest. Heart & Lung. 2013 Jul;42(4):267-269. https://doi.org/10.1016/j.hrtlng.2013.04.002
Brundridge W, Perkins J. Iodinated Contrast Administration Resulting in Cardiogenic Shock in Patient with Uncontrolled Graves Disease. The Journal of Emergency Medicine. 2017 Dec;53(6):e125-e128. https://doi.org/10.1016/j.jemermed.2017.08.096
Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis A. Iodine-Induced Hypothyroidism. Thyroid. 2001 May;11(5):501-510. https://doi.org/10.1089/105072501300176462
Cooper DS. Antithyroid Drugs. New England Journal of Medicine. 2005 Mar 3;352(9):905-917. https://doi.org/10.1056/nejmra042972
Wolff J. Perchlorate and the thyroid gland. Pharmacol Rev. 1998;50(1):89-105.
Nolte W, Müller R, Siggelkow H, Emrich D, Hüfner M. Prophylactic application of thyrostatic drugs during excessive iodine exposure in euthyroid patients with thyroid autonomy: a randomized study. European Journal of Endocrinology. 1996 Mar;134(3):337-341. https://doi.org/10.1530/eje.0.1340337
Fritzsche H, Benzer W, Furlan W, Hammerle D, Langsteger W, Weiss P. Zur Vorbeugung jodinduzierter Hyperthyreosen nach Koronarangiographie [Prevention of iodine-induced hyperthyroidism after coronary angiography]. Acta Med Austriaca. 1-2;1993(20):13-7. PMID 8386417
Fricke E, Fricke H, Esdorn E, Kammeier A, Lindner O, Kleesiek K, Horstkotte D, Burchert W. Scintigraphy for Risk Stratification of Iodine-Induced Thyrotoxicosis in Patients Receiving Contrast Agent for Coronary Angiography: A Prospective Study of Patients with Low Thyrotropin. The Journal of Clinical Endocrinology & Metabolism. 2004 Dec;89(12):6092-6096. https://doi.org/10.1210/jc.2004-0728
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