Introduction: Iodinated contrast media (ICM)-induced hyperthyroidism is an underestimated, potentially severe condition; however, its prevention has not been sufficiently investigated. The aim of this study was to evaluate the influence of ICM on thyroid status, the advantages of prophylactic therapy for iodine-induced hyperthyroidism (IIH) in patients with euthyroid goiter and cardiovascular comorbidities, and the association between the incidence of IIH and thyroid volume. Methods: Thirty-six euthyroid patients undergoing procedures involving ICM administration were divided into 2 groups: the first group (n = 13) received prophylactic treatment with thiamazole or thiamazole combined with sodium perchlorate during ICM exposure; the second group (n = 23) did not receive prophylaxis. Thyroid-stimulating hormone levels were evaluated before and after ICM, and thyroid hormone levels were assessed after ICM at different points in time. The morphology of the thyroid was evaluated by ultrasonography. Results: Twenty-one patients (58%) developed hyperthyroidism after ICM. Hyperthyroidism was observed more frequently in the group without prophylactic treatment than in the group with prophylaxis (65 vs. 15%, respectively; p = 0.006). No cases of overt hyperthyroidism were observed in the group receiving thiamazole with sodium perchlorate. IIH persisted for a median time of 52.5 days. Larger thyroid volume was associated with a significantly higher occurrence of ICM-induced hyperthyroidism (p = 0.04). Conclusions: Patients with euthyroid goiter receiving ICM are at risk of developing hyperthyroidism. The occurrence of hyperthyroidism after ICM in euthyroid patients with goiter is higher in those with larger thyroid volume. The frequency of ICM-induced hyperthyroidism in euthyroid patients with goiter is lower in those receiving prophylactic therapy with thiamazole in monotherapy or in combination with sodium perchlorate than in those not receiving prophylactic treatment.
Eur Thyroid J

中文翻译：

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甲状腺功能正常的甲状腺肿患者预防碘造影剂诱发的甲状腺功能亢进症


简介：碘造影剂 (ICM) 诱发的甲状腺功能亢进症是一种被低估的潜在严重疾病；然而，其预防尚未得到充分研究。本研究的目的是评估 ICM 对甲状腺状态的影响、甲状腺功能正常的甲状腺肿和心血管合并症患者预防性治疗碘诱发的甲状腺功能亢进症 (IIH) 的优势，以及 IIH 发生率与甲状腺体积之间的关系。方法： 36 例接受 ICM 给药手术的甲状腺功能正常患者分为 2 组：第一组（ n = 13）在 ICM 暴露期间接受甲硫咪唑或甲硫咪唑联合高氯酸钠预防治疗；第二组（ n = 23）没有接受预防。在 ICM 之前和之后评估促甲状腺激素水平，并在 ICM 后不同时间点评估甲状腺激素水平。通过超声检查评估甲状腺的形态。结果： 21 名患者 (58%) 在 ICM 后出现甲状腺功能亢进症。未进行预防性治疗的组中观察到甲状腺功能亢进的频率高于进行预防性治疗的组（分别为 65% 和 15%； p = 0.006）。在接受甲硫咪唑和高氯酸钠治疗的组中没有观察到明显的甲状腺功能亢进病例。 IIH 持续的中位时间为 52.5 天。较大的甲状腺体积与 ICM 诱发的甲状腺功能亢进症的发生率显着升高相关 ( p = 0.04)。结论：接受 ICM 治疗的甲状腺肿正常患者有发生甲状腺功能亢进的风险。 甲状腺功能正常的甲状腺肿患者 ICM 后甲状腺功能亢进的发生率在甲状腺体积较大的患者中更高。在甲状腺功能正常的甲状腺肿患者中，接受噻唑啉单药治疗或与高氯酸钠联合治疗的患者中，ICM 诱发的甲状腺功能亢进的发生率低于未接受预防性治疗的患者。
 欧洲甲状腺杂志