Case Report Increased serum iodide concentration from iodine absorption through wounds treated topically with povidone-iodine

Aronoff, George R.; Friedman, Stewart J.; Doedens, David J.; Lavelle, Kevin J.

doi:10.1097/00000441-198005000-00007

Cited by 40 publications

(18 citation statements)

References 9 publications

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“…These reports suggest that transcutaneous absorption of iodine may cause iodine toxicosis. Patients with renal dysfunction are extremely susceptible to iodine intoxication (11,12,14) because inorganic iodine is primarily eliminated by renal metabolism (12). These data suggest that iodine concentrations in the urine reflect the plasma iodine levels (15).…”

Section: Discussionmentioning

confidence: 97%

A Case of Consciousness Disturbance Resulting from Severe Hypothyroidism due to Chronic Thyroiditis and Excess Iodine Absorption

et al. 2011

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An 82-year-old Japanese man had consciousness disturbance due to severe hypothyroidism triggered by percutaneous absorption of iodine from an iodine-containing ointment used in diabetic gangrene treatment. Laboratory data revealed extremely high urinary iodine concentrations, and chronic thyroiditis-induced hypothyroidism. Excess iodine intake can also cause hypothyroidism. It was unlikely that iodine intoxication or Hashimoto's encephalopathy had caused the consciousness disturbance. The patient regained consciousness after discontinuing the use of the ointment and commencing thyroid hormone therapy. We conclude that consciousness disturbance resulted from severe hypothyroidism caused by chronic thyroiditis and excess iodine absorption.

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Section: Discussionmentioning

confidence: 97%

A Case of Consciousness Disturbance Resulting from Severe Hypothyroidism due to Chronic Thyroiditis and Excess Iodine Absorption

et al. 2011

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“…The pre-terminal phase of acute systemic iodine/iodide toxicity is due to the high serum iodine concentration which can cause refractory high anion gap metabolic acidosis, lactic acidosis, cardiogenic shock and death 7,19 . The presence of a halide gap may indicate iodide retention 14 .…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Collapse following Povidone-Iodine Wash

Ramaswamykanive

Nanavati

Mackie

et al. 2011

Anaesth Intensive Care

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We present a case study of a severe episode of iodine toxicity following povidone-iodine wash with clinical manifestations of cardiovascular collapse, metabolic acidosis, renal failure and seizures. Povidone-iodine has been used as a medical antiseptic and disinfectant since 1952. Iodine toxicity secondary to povidone-iodine use is rare. Iodine toxicity is difficult to diagnose and the diagnosis is made by a high index of suspicion. Toxicity due to iodine correlates with serum and urine iodine levels. Treatment of iodine toxicity is supportive. A review of literature relating to the components of povidone-iodine, iodine metabolism, its manifestations and management of iodine toxicity secondary to povidone-iodine is also presented. An Ovid-Medline search from 1950 to 2009 revealed 1236 articles on the clinical manifestations of povidone-iodine usage but no article on iodine toxicity relating to povidone-iodine based on the following search criteria: povidone-iodine and/or iodine toxicity secondary to povidone-iodine (limited to English language, review articles, full text and human patients).

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“…Systemic iodine toxicity has been well documented following the topical application of povidone‐iodine to burns 3 or mediastinal wounds 4 particularly in the setting of impaired renal function 5 . Major systemic effects reported have included metabolic acidosis, 3 cardiovascular instability (hypotension, brachycardia), renal failure, 5 leukocytoclastic vasculitis, 6 hyperthyroidism 7 and abnormal liver function 2 . Elevated serum iodine levels have been documented and haemodialysis has been used to reduce levels quickly with reversal of signs of toxicity 4 .…”

Section: Discussionmentioning

confidence: 99%