Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Rhee, Connie M.; Bhan, Ishir; Alexander, Erik K.; Brunelli, Steven M.

doi:10.1001/archinternmed.2011.677

Cited by 197 publications

(163 citation statements)

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“…Recognition in this highly competitive protic media has predominantly been the domain of highly charged hydrogen‐bonding receptors, which are frequently pH‐dependent3 or metal‐cation‐based systems;4–6 although some recent progress has been made in exploiting the hydrophobic effect for anion recognition by neutral host species 7–10. Amongst the plethora of biologically and medically relevant anions, the recognition and sensing of iodide in water is of interest both due to its crucial role in hormone biosynthesis by the thyroid gland11, 12 and its use in contrast media for radiographic imaging applications 13. Examples of anion hosts capable of sensing iodide by optical methods are scarce,14–17 and to the best of our knowledge, the use of molecular‐anion receptors for the host–guest recognition and sensing of iodide in water is unprecedented.…”

Section: Introductionmentioning

confidence: 99%

Iodide Recognition and Sensing in Water by a Halogen‐Bonding Ruthenium(II)‐Based Rotaxane

Langton

Marques

Robinson

et al. 2015

Chemistry A European J

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The synthesis and anion‐recognition properties of the first halogen‐bonding rotaxane host to sense anions in water is described. The rotaxane features a halogen‐bonding axle component, which is stoppered with water‐solubilizing permethylated β‐cyclodextrin motifs, and a luminescent tris(bipyridine)ruthenium(II)‐based macrocycle component. 1H NMR anion‐binding titrations in D2O reveal the halogen‐bonding rotaxane to bind iodide with high affinity and with selectively over the smaller halide anions and sulfate. The binding affinity trend was explained through molecular dynamics simulations and free‐energy calculations. Photo‐physical investigations demonstrate the ability of the interlocked halogen‐bonding host to sense iodide in water, through enhancement of the macrocycle component’s RuII metal–ligand charge transfer (MLCT) emission.

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Section: Introductionmentioning

confidence: 99%

Iodide Recognition and Sensing in Water by a Halogen‐Bonding Ruthenium(II)‐Based Rotaxane

Langton

Marques

Robinson

et al. 2015

Chemistry A European J

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“…Advanced age, large thyroid volume, multinodular goiter and thyroid autonomy make the risk group in development of iodine-related thyrotoxicosis (27). The history of nontoxic diffuse or nodular goiter that occurs most frequently in the areas of iodine deficiency could not be well ascertained in Rhee et al (22), although this is the most commonly reported risk factor for iodine-induced hyperthyroidism.…”

Section: Discussionmentioning

confidence: 99%

“…The iodine-containing contrast media for imaging purposes such as coronary angiography (CA), is widespread use result in considerable iodine load of the thyroid gland, which is mainly caused by in vivo deiodination of the contrast medium (17,18). Several studies have reported thyroid dysfunction following administration of contrast agent (16,(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

“…Two of these subjects developed hyperthyroidism and one subject was reported to develop atrial fibrillation (30). Rhee et al (22) report the findings of a nested case-control study examining associations between exposure to iodinated radiologic contrast media and development of incident thyroid dysfunction. They describe significant associations between contrast exposure and the development of hyperthyroidism.…”

Section: Discussionmentioning

confidence: 99%

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Thyroid functions after contrast agent administration for coronary angiography: a prospective observational study in euthyroid patients

Özkan¹,

Semiz-Oysu²,

Kayataş³

et al. 2013

Anadolu Kardiyol Derg

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Objective: This study aims to investigate long-term effects of iodinated radiographic contrast media used for coronary angiography (CAG) on the thyroid function in euthyroid patients. Methods: In a prospective observational cohort study, nonionic iodinated contrast material was electively used in 101 patients for coronary angiography. The patients were recruited without age restrictions and, at baseline, all had normal levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH). The morphology of the thyroid was evaluated by thyroid ultrasonography (USG). Four and eight weeks after CAG, serum TSH, FT3 and FT4 levels were assessed. Results: Compared to a mean baseline level of 1.49 (25%-75%, range 13-2.21), follow-up TSH levels decreased significantly to 1.45 (25%-75%, range 1.98-0.92, p=0.017) and 1.40 (25%-75%, range 1.89-0.87, p=0.003) at 4 weeks and 8 weeks, respectively (p=0.008). No significant diffe-rence was observed in TSH levels between the 4 th and 8 th weeks (p=0.833). Conclusion: Iodinated radiographic contrast agents may cause subclinical hyperthyroidism in euthyroid patients undergoing CAG. (

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“…We obtained data through the Partners Healthcare Research Patient Data Registry, a central clinical data warehouse for .1.8 million inpatients and outpatients designed for research and quality improvement (23)(24)(25). Approval for this study was granted by the Institutional Review Board at Brigham and Women's Hospital and the need for informed consent was waived.…”

Section: Data Collectionmentioning

confidence: 99%

Incidence, Outcomes, and Comparisons across Definitions of AKI in Hospitalized Individuals

Zeng

McMahon

Brunelli³

et al. 2014

Clinical Journal of the American Society of Nephrology

378

258

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SummaryBackground and objectives At least four definitions of AKI have recently been proposed. This study sought to characterize the epidemiology of AKI according to the most recent consensus definition proposed by the Kidney Disease Improving Global Outcomes (KDIGO) Work Group, and to compare it with three other definitions.Design, setting, participants, & measurements This was a retrospective cohort study of 31,970 hospitalizations at an academic medical center in 2010. AKI was defined and staged according to KDIGO criteria, the Acute Dialysis Quality Initiative's RIFLE criteria, the Acute Kidney Injury Network (AKIN) criteria, and a definition based on a model of creatinine kinetics (CK). Outcomes of interest were incidence, in-hospital mortality, length of stay, costs, readmission rates, and posthospitalization disposition.Results AKI incidence was highest according to the KDIGO definition (18.3%) followed by the AKIN (16.6%), RIFLE (16.1%), and CK (7.0%) definitions. AKI incidence appeared markedly higher in those with low baseline serum creatinine according to the KDIGO, AKIN, and RIFLE definitions, in which AKI may be defined by a 50% increase over baseline. AKI according to all definitions was associated with a significantly higher risk of death and higher resource utilization. The adjusted odds ratios for in-hospital mortality in those with AKI were highest with the CK definition (5.2; 95% confidence interval [95% CI], 4.1 to 6.6), followed by the RIFLE (2.9; 95% CI, 2.2 to 3.6), KDIGO (2.8; 95% CI, 2.2 to 3.6), and AKIN (2.6; 95% CI, 2.0 to 3.3) definitions. Concordance in diagnosis and staging was high among the KDIGO, AKIN, and RIFLE definitions. ConclusionsThe incidence of AKI in hospitalized individuals varies depending on the definition used. AKI according to all definitions is associated with higher in-hospital mortality and resource utilization. AKI may be inappropriately diagnosed in those with low baseline serum creatinine using definitions that incorporate percentage increases over baseline.

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Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Abstract: Iodinated contrast media exposure is associated with subsequent development of incident hyperthyroidism and incident overt hypothyroidism.

Cited by 197 publications

References 50 publications

Iodide Recognition and Sensing in Water by a Halogen‐Bonding Ruthenium(II)‐Based Rotaxane

Iodide Recognition and Sensing in Water by a Halogen‐Bonding Ruthenium(II)‐Based Rotaxane

Thyroid functions after contrast agent administration for coronary angiography: a prospective observational study in euthyroid patients

Incidence, Outcomes, and Comparisons across Definitions of AKI in Hospitalized Individuals

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