Abstract
Backgroundexposure to iodinated contrast media (ICM) can cause hyperthyroidism, due to disruption of thyroid hormone regulation. Although rare, it can have severe consequences and can lead to fatal complications. Current guidelines do not recommend standard laboratory testing of the thyroid function prior to ICM exposure. Prophylactic treatment of patients at higher risk of hyperthyroidism is not advised.Case presentationwe report the case of an 82-year-old woman who developed ICM induced hyperthyroidism after undergoing a chest computed tomography (CT). One month after ICM administration she presented with pneumonia at the emergency department. Hyperthyroidism was found with concomitant tachycardia, which was hard to control. As a result of hyperthyroidism and coincidental pneumonia the patient developed heart failure and died of myocardial ischemia.Conclusionsthis case report underlines the importance of close monitoring of high-risk patients after ICM exposure. Clinicians should be aware of the risk of hyperthyroidism and potential severe complications. The use of ICM needs careful consideration, especially in the elderly who suffer more often from multinodular goitre.
Highlights
There are several causes for the development of hyperthyroidism, of which the most common causes are Graves’ disease and thyroid autonomy
We aim to present a case of iodinated contrast media (ICM) induced hyperthyroidism that has contributed to a heart failure-related complication secondary to an ischemic event
In retrospect, the hyperthyroidism was most likely provoked by administration of ICM during the initial chest computed tomography (CT) and contributed to the sustained tachycardia
Summary
There are several causes for the development of hyperthyroidism, of which the most common causes are Graves’ disease and thyroid autonomy. Conclusions: this case report underlines the importance of close monitoring of high-risk patients after ICM exposure. Exposure to iodinated contrast media (ICM) can cause hyperthyroidism, due to disruption of thyroid hormone regulation. Current guidelines of the Radiological Society of the Netherlands and the Netherlands Association of Internal Medicine do not recommend standard laboratory testing of the thyroid function or thyroid ultrasound investigation prior to ICM exposure [6, 7].
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