Changes in Serum Iodine Concentration, Urinary Iodine Excretion and Thyroid Function After Hysterosalpingography Using an Oil-Soluble Iodinated Contrast Medium (Lipiodol)

Abstract

Thyroid monitoring should be conducted in the first 4-8 weeks after HSG using lipiodol and attention to thyroid dysfunction should be paid for up to 6 months after the procedure due to the possibility of excess iodine.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

“…Multiple observational studies have examined changes in thyroid hormone levels following a single exposure to intravenous iodinated contrast in both iodine-sufficient (562)(563)(564)(565) and iodine-deficient (566-569) regions. A study of patients living in Boston showed that 5 of 49 (10.2%) developed a suppressed TSH value 1-4 weeks following exposure to a single computed tomography (CT) study with contrast, with only one patient developing overt hyperthyroidism (565).…”

“…A study of patients living in Boston showed that 5 of 49 (10.2%) developed a suppressed TSH value 1-4 weeks following exposure to a single computed tomography (CT) study with contrast, with only one patient developing overt hyperthyroidism (565). Additional observational studies in the United States and Japan involving 56 and 22 patients, respectively, found no new cases of hyperthyroidism following coronary angiography (564) or hysterosalpingography (563), whereas an Australian study from a region of iodine sufficiency found that 2 of 72 (2.8%) of patients developed overt hyperthyroidism and an additional two patients developed subclinical hyperthyroidism within 8 weeks of iodinated contrast exposure (562). Overall, similar rates of iodine-induced hyperthyroidism have been described in iodine-deficient regions, including a study from Germany in which 2 of 788 (0.25%) patients developed overt hyperthyroidism following coronary angiography (566), a New Zealand study in which subclinical hyperthyroidism developed in 2 of 102 (2%) patients after a CT scan with iodinated contrast (567), a study from Italy that found that 1.9% of 1752 patients undergoing coronary angiography developed a suppressed TSH with normal free T 4 and T 3 levels (568), and finally, a Turkish study identifying new subclinical hyperthyroidism in 5.9% of 101 patients by 8 weeks following coronary angiography (569).…”

Thyroid Dysfunction in Neonates Born to Mothers Who Have Undergone Hysterosalpingography Involving an Oil-Soluble Iodinated Contrast Medium

“…Kaneshige et al [20] also reported that 3 out of 22 Japanese euthyroid women showed transient subclinical hypothyroidism after ethiodized-oil HSG. Moreover, at least 8 Japanese fetuses or neonates with thyroid dysfunction after maternal HSG involving the use of ethiodized oil have been described in the literature [8] or scientific meetings during the past 10 years.…”

Implications of thyroid autoimmunity in infertile women with subclinical hypothyroidism in the absence of both goiter and anti-thyroid antibodies: lessons from three cases

“…Twelve infertile women with TGAb and TPOAbnegative nongoitrous SH were referred to our department of endocrinology by gynecologists at Shinonoi General Hospital between September 2007 and September 2015. Thyroid related data for diagnosis of SH were collected before all infertility examinations and treatments, because TSH secretion is likely to be stimulated by a series of infertility examinations and treatments [11,12]. None of the patients had been diagnosed with autoimmune thyroid disease or had any possible causes of SH.…”