Iodine-induced hypothyroidism in patients on regular dialysis treatment.
Hypothyroidism with a serum concentration of thyroid-stimulating hormone (TSH) above 40 microU/ml was noted in 3 (3.2%) of 93 patients on regular hemodialysis or continuous ambulatory peritoneal dialysis. These 3 patients had no history of thyroid disease and were receiving no medication known to influence thyroid function. They had habitually eaten iodine-rich foods and showed an enlarged thyroid gland with a preserved radioactive iodine uptake and a markedly elevated serum inorganic iodine (II) level. In all 3 patients, both thyroidal microsomal antibody and thyroglobulin antibody titers measured by hemagglutination methods were less than 100, and TSH-binding inhibitory immunoglobulin was negative. Moreover, histologically no lymphocytic infiltrations were observed. With only iodine restriction, serum TSH level markedly decreased from 44.6 to 3.6 microU/ml in case 1, from 90.6 to 3.2 microU/ml in case 2 and from 43.2 to 9.4 microU/ml in case 3 in parallel with decreases in the serum II level. These results suggest that at least in an area like Japan, where the daily intake of iodine is high, iodine-induced hypothyroidism may be induced in patients undergoing regular dialysis treatment even in the absence of apparent underlying thyroid disease.
Takeda
S
S
Kurobe City Hospital Toyama, Japan.
Michigishi
T
T
Takazakura
E
E
D000328:Adult; D004032:Diet / Q000009:adverse effects; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000209:etiology* / Q000473:pathology; D007455:Iodine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D013972:Thyrotropin / Q000097:blood
D013972:Thyrotropin; D007455:Iodine