F Eilsberger1, M Luster2, J Feldkamp3. 1. Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Baldingerstraße, 35043, Marburg, Deutschland. friederike.mueller@staff.uni-marburg.de. 2. Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Baldingerstraße, 35043, Marburg, Deutschland. 3. Klinik für Allgemeine Innere Medizin, Endokrinologie, Diabetologie, Infektiologie, Klinikum Bielefeld Mitte, Bielefeld, Deutschland.
Abstract
BACKGROUND: Iodine-induced thyroid dysfunctions are, despite their rare occurrence, important clinical syndromes. Their immediate recognition can avoid serious consequences. Important triggers can be iodine-containing contrast agents, amiodarone or iodine-containing disinfectants. Iodine-induced hypothyroidism and hyperthyroidism need to be distinguished, whereby the former is usually self-limiting. OBJECTIVES: The aim of this article is to present current knowledge on the pathogenesis, therapy, and prophylaxis of iodine-induced thyroid dysfunction. MATERIALS AND METHODS: We performed a literature search of current publications and linked them to daily clinical experience. RESULTS AND CONCLUSION: In iodine-induced hyperthyroidism, antithyroid drugs and perchlorate are primarily used to decrease thyroid hormone synthesis and further iodine uptake into the thyroid. For the prophylaxis of x‑ray contrast agent-induced hyperthyroidism, perchlorate can be administered in high-risk settings in combination with antithyroid drugs, if possible starting one day before the iodine exposure.
BACKGROUND: Iodine-induced thyroid dysfunctions are, despite their rare occurrence, important clinical syndromes. Their immediate recognition can avoid serious consequences. Important triggers can be iodine-containing contrast agents, amiodarone or iodine-containing disinfectants. Iodine-induced hypothyroidism and hyperthyroidism need to be distinguished, whereby the former is usually self-limiting. OBJECTIVES: The aim of this article is to present current knowledge on the pathogenesis, therapy, and prophylaxis of iodine-induced thyroid dysfunction. MATERIALS AND METHODS: We performed a literature search of current publications and linked them to daily clinical experience. RESULTS AND CONCLUSION: In iodine-induced hyperthyroidism, antithyroid drugs and perchlorate are primarily used to decrease thyroid hormone synthesis and further iodine uptake into the thyroid. For the prophylaxis of x‑ray contrast agent-induced hyperthyroidism, perchlorate can be administered in high-risk settings in combination with antithyroid drugs, if possible starting one day before the iodine exposure.