Risk of iodine-induced thyrotoxicosis after coronary angiography: an investigation in 788 unselected subjects

Hintze, G.; Blombach, O; Fink, H.; Burkhardt, Ute; Köbberling, J.

doi:10.1530/eje.0.1400264

Cited by 74 publications

(42 citation statements)

References 14 publications

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“…[21][22][23][24][25][26] To address these limitations, we conducted a nested casecontrol study to assess the association between ICM exposure and incident thyroid dysfunction.…”

Section: See Invited Commentary and Editor' S Note At End Of Articlementioning

confidence: 99%

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Rhee

Bhan²,

Alexander³

et al. 2012

Arch Intern Med

197

145

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“…[21][22][23][24][25][26] To address these limitations, we conducted a nested casecontrol study to assess the association between ICM exposure and incident thyroid dysfunction.…”

Section: See Invited Commentary and Editor' S Note At End Of Articlementioning

confidence: 99%

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Rhee

Bhan²,

Alexander³

et al. 2012

Arch Intern Med

197

145

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show abstract

“…Iodine-induced hyperthyroidism has been reported in patients with a variety of underlying thyroid diseases, but primarily occurs in individuals with nodular thyroid disease (9,10). Martin et al showed development of hyperthyroidism after the use of contrast agents (11).…”

Section: Introductionmentioning

confidence: 99%

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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“…Goiter was present in 63% of the patients and the majority of them were elderly. In a large study in unselected patients, only 2 of 788 developed hyperthyroidism within 12 weeks of coronary angiography [14]. Administration of non-ionic iodinated contrast medium to 102 euthyroid patients did not lead to hyperthyroidism in any patient despite the large number of nodularly transformed glands and patients with goiter [15].…”

Section: Clinical Studies Of Contrast Media Induced Thyrotoxicosismentioning

confidence: 90%

Effect of iodinated contrast media on thyroid function in adults

2004

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Excess free iodide in the blood (ingested or injected) may cause thyrotoxicosis in patients at risk. Iodinated contrast medium solutions contain small amounts of free iodide and may be of significance for patients at risk. The free iodide may also interfere with nuclear medicine diagnostic studies and treatment. Therefore the Contrast Media Safety Committee of the European Society of Urogenital Radiology reviewed the literature on this subject in order to prepare guidelines. A report and guidelines were prepared based on an extensive Medline search. The report was discussed with the participants attending the Tenth European Symposium on Urogenital Radiology, Uppsala, Sweden, September 2003. Contrast medium induced thyrotoxicosis is rare. Contrast medium injection does not affect thyroid function tests (e.g., T3, T4, TSH) in patients with a normal thyroid. Routine monitoring of thyroid function tests before contrast medium injection in patients with a normal thyroid is not indicated even in areas where there is dietary iodine deficiency. Patients at risk of developing thyrotoxicosis after contrast medium injection are patients with Graves' disease and patients with multinodular goiter with thyroid autonomy, especially elderly patients and patients living in areas of iodine deficiency. Patients at high-risk should be carefully monitored by endocrinologists after contrast medium examinations. Prophylaxis in these groups is not generally recommended, although it may offer some protection in selected high-risk individuals. The free iodide load of contrast media injections interferes with iodide uptake in the thyroid and therefore compromises diagnostic thyroid scintigraphy and radio-iodine treatment of thyroid malignancies for 2 months after administration of contrast media. Simple guidelines on the subject are proposed.

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Risk of iodine-induced thyrotoxicosis after coronary angiography: an investigation in 788 unselected subjects

Cited by 74 publications

References 14 publications

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism

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

Effect of iodinated contrast media on thyroid function in adults

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