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Iodinated Contrast Media Induced Hyperthyroidism

NCT04304794 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 36

Last updated 2020-03-11

No results posted yet for this study

Summary

The proper synthesis of thyroid hormones is dependent on adequate iodine supply. The mean daily iodine intake recommended by World Health Organization is 150 mg. Iodinated contrast medium (ICM) typically contains 13 500 mg of free iodine and 15-60 g of bound iodine, an amount well above acceptable upper level. In a situation of excess iodine, thyroid discontinues the release of hormones (Wolff-Chaikoff effect), which is usually transient, although can persist causing hypothyroidism. Iodine-induced hyperthyroidism (IIH), known as the Jod-Basedow phenomenon is infrequent, but elderly patients and individuals with autonomously functioning nodular goiters are at higher risk of developing this dysfunction. According to recent studies the risk of ICM-induced hyperthyroidism appears to be low. The prevalence has not been well assessed and varies from 1 % to 10 %. Currently, there are no specific guidelines concerning the prophylactic therapy of IIH. American Thyroid Association (ATA) does not recommend routine administration of antithyroid drugs before iodinated contrast medium for all patients, however, advises to consider prophylaxis in patients at high risk of developing IIH or with cardiovascular comorbidities. ATA recommends avoidance of additional iodine and administration of b-blockers alone or with antithyroid drugs as a treatment of IIH, depending on the severity of hyperthyroidism.

This study was performed to evaluate the influence of ICM on thyroid status and advantages of prophylactic therapy during ICM exposure in patients with euthyroid goiter and cardiovascular comorbidities. The association between the incidence of IIH and thyroid volume was also assessed.

Conditions

  • Hyperthyroidism/Thyrotoxicosis
  • Hyperthyroidism; Goiter
  • Iodine Induced Thyrotoxicosis
  • Contrast Media Adverse Reaction
  • Thyrotoxicosis of Other Specified Origin

Interventions

PROCEDURE

Administration of iodinated contrast media

Each patient was exposed on iodinated contrast medium administered during computed tomography, coronary angiography or transcatheter aortic valve implantation.

DRUG

Prophylactic administration of antithyroid drugs before iodinated contrast media exposure

13 patients received thiamazole with (6 patients) or without (7 patients) sodium perchlorate, one day prior to iodinated contrast medium (ICM) and for at least 14 days after for thiamazole (20-40 mg/daily) and 10 days after for sodium perchlorate (900 mg/daily).

Sponsors & Collaborators

  • National Institute of Cardiology, Warsaw, Poland

    collaborator OTHER

  • Medical University of Warsaw

    lead OTHER

Principal Investigators

  • Piotr Miśkiewicz, MD, PhD · Department of Endocrinology Medical University of Warsaw

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2015-01-02
Primary Completion
2020-02-20
Completion
2020-02-20

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT04304794 on ClinicalTrials.gov