A low incidence of iodine‐induced hyperthyroidism following administration of iodinated contrast in an iodine‐deficient region
Open accessAbstract
Summary: Objective: There are limited data on the incidence of iodinated contrast‐induced thyrotoxicosis, particularly in iodine‐deficient regions. The aim of this study was to determine the incidence of iodinated contrast‐induced thyrotoxicosis and to determine whether thyrotoxicosis was more common in patients ≥70 years compared to those <70 years of age. Design: A prospective study of adult patients undergoing an outpatient CT with iodinated contrast was performed. Measurements: Thyroid function tests (TFT s) and urine iodine measurements were performed prior to the scan. TFT s were repeated at 4‐ and 8‐weeks postscan. Changes in TFT s from baseline were analysed. Results: A total of 102 patients were included in the final analysis. Overall, TSH levels dropped (P = 0·0002), and free T 3 (FT3) levels increased (P = 0·04) between baseline and week 4 with normalization by week 8; however, these changes were not considered clinically significant. No significant differences in free T 4 (FT4) occurred in the overall group (P = 0·82). There were no differences in TFT s between baseline and 4 or 8 weeks for those patients aged <70 compared to ≥70 years. Two patients developed new subnormal TSH values. Of these, one had a 90‐mm follicular variant papillary thyroid carcinoma diagnosed while the other had a normal thyroid assessment and TSH spontaneously normalized by 12 weeks. Conclusions: Only 2% of patients developed subclinical hyperthyroidism following a standard dose of iodinated contrast for CT investigations. Given the low incidence of iodine‐induced thyrotoxicosis, there is no indication for routine pre‐ and post‐CT thyroid function testing in our region.
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In a New Zealand study, subclinical hyperthyroidism developed in 2 of 102 (2%) patients after a CT scan with iodinated contrast.
“a New Zealand study in which subclinical hyperthyroidism developed in 2 of 102 (2%) patients after a CT scan with iodinated contrast (567)”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [567]
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“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.”
Background
- Authors
- Jarvis, C., Simcox, K., Tamatea, J. A. U., McAnulty, K., Meyer‐Rochow, G. Y., Conaglen, J. V., & Elston, M. S.
- Affiliations
- Waikato Hospital (NZ)
- Department of Surgery Waikato Hospital Hamilton New Zealand
- University of Auckland (NZ)
- Corresponding author
- Elston, Marianne S.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2015-06-19
- Volume
- 84
- Issue
- 4
- Pages
- 558-563
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W1847388526
- Cited by
- 21
- References
- 23
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 1 · 2016: 2 · 2015: 1 · 2014: 1
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Funders
- Waikato Medical Research Foundation (208)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- iodinated contrast media, iodine deficiency, subclinical hyperthyroidism, computed tomography, thyroid function tests, thyroid-stimulating hormone, free T3, free thyroxine, elderly patients, iodine supplementation, follicular variant of papillary thyroid carcinoma
- MeSH terms
- Adult, Aged, Aged, 80 and over, Contrast Media, Female, Humans, Hyperthyroidism, Iodine, Male, Middle Aged, New Zealand, Outpatients, Prospective Studies, Thyroid Function Tests, Thyrotropin, Thyroxine, Time Factors, Tomography, X-Ray Computed, Triiodothyronine, Incidence
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