Iodide-induced Hyperthyroidism Within Four Hours of Iodide Load: A Case Report and Review

Abstract

The recommended amount of iodide consumption for the majority of adults is approximately 150 mcg per day. During a computed tomography scan, patients can receive 14 to 35 million mcg of iodinated contrast. A 46-year-old African female with no known prior thyroid disease presented with dyspnea and tachycardia. She underwent computed tomography angiogram of the chest to rule out pulmonary embolism. She had evidence of hyperthyroidism four hours after receiving iodinated contrast. We presumed that her hyperthyroidism was a consequence of the Jod-Basedow phenomenon due to an underlying multinodular goiter that was later discovered.

Weathering the Storm: Thyroid Storm Precipitated by Radioiodine Contrast in Metastatic Thyroid Carcinoma

“…Hormonally active thyroid metastatic lesions are not common and have been described mostly with follicular thyroid carcinoma [ 8 ]. Other high-risk groups for iodine-induced thyrotoxicosis include multinodular goiter, Graves' disease, residing in an iodide-deficient area, and the elderly population [ 9 ]. In this patient with thyroidectomy, thyroid cancer metastasis was responsible for precipitating thyroid storm following iodine contrast administration since she had normal thyroid function tests before this hospitalization.…”

“…This induced hyperthyroidism develops variably from few days to 16 weeks following the administration of the iodinated contrast [ 7 , 12 ]. Torres et al had presented a case of iodide-induced hyperthyroidism within four hours of iodine exposure; this was reported as one of the shortest courses between iodine contrast administration and symptoms manifestation [ 9 ].…”