Prevention and Treatment of Iodine-Induced Thyrotoxicosis

Abstract

Etiologies of thyrotoxicosis are diverse, one of them being caused by iodineinduced hyperthyroidism. The clinical signs of the disease are the classical signs of any form of hyperthyroidism, but the treatment of the different forms presents particular aspects. This chapter reviews the risk factors for thyrotoxicosis following an excess iodine load, pointing out the major sources of iodine: supplementation programs, dietary intake, nutritional supplements, iodine-containing contrast medium, and amiodarone. Prevention of iodine-induced thyrotoxicosis is critical in geriatric patients who often have thyroid nodular disease, underlying heart conditions, and therefore, hyperthyroidism may be more difficult to detect clinically. Treatment of iodine-induced thyrotoxicosis could be performed with thioamides or perchlorate prior to the administration of an iodine containing product (e.g., food, dietary supplements, and contrast media). On the other hand, amiodarone-induced thyrotoxicosis needs further attention and a close collaboration between cardiology and endocrinology to overcome complications, but individualization of the therapy should be undertaken. Based on the specific features of amiodarone-induced thyrotoxicosis thioamides, perchlorate, high-dose glucocorticoids, or radioiodine therapy may be considered for an optimal therapeutic intervention.

Initially Suspected Anaphylaxis Following Iodinated Contrast: Jod-Basedow Phenomenon in a 73-Year-Old Female Without a History of Thyroid Dysfunction

“…The JB phenomenon is primarily self-limited in most cases with the mainstay of management being source control and discontinuation of iodine exposure [ 8 ]. Additionally, preventative management is key such as utilizing non-contrast CT or MRI imaging when possible.…”

“…Additionally, preventative management is key such as utilizing non-contrast CT or MRI imaging when possible. Current trials have not mounted enough evidence on the use of thioamide or percolate for the treatment of the JB phenomenon, thereby frequent lab monitoring of TSH and ft4 post-iodinated contrast use can be helpful [ 8 ]. If medication-induced, such as an instance of amiodarone use, management must be individualized based on the severity of cardiac history.…”

“…Sudden withdrawal can potentiate more harm by worsening hyperthyroid signs and symptoms. In such cases, after a euthyroid state is achieved, radioactive iodine or total thyroidectomy can be considered [ 8 ]. Another modality available is plasmapheresis, which has shown beneficial effects for the removal of excess hormones in many cases [ 8 ].…”

Polymeric micelles with chiral diamine-Ru(II) catalysts for asymmetric transfer hydrogenation of ketones in water

“…For example, J. Margalef et al [17] successfully prepared a complete and modular ligand library using a variety of amino alcohols and amino acids as feedstocks, and the asymmetric transfer hydrogenation of ketones achieved by the ligand coordinates with ruthenium or rhodium catalysts efficiently. Vanessza, J. K. et al [18] have successfully realized the mechanochemical energy transmission process in an aqueous medium by a chiral Ru catalyst. A new environmentally friendly type system of asymmetric transfer hydrogenation is established, and highyield optically enriched alcohols are obtained.…”