Femoral fracture and iatrogenic hyperthyroidism in spinal cord injury.
Analysis of the clinical case of a male aged 30 years, presenting with T6 complete paraplegia in 1991, demonstrated the existence of aggravating factors for disuse osteoporosis of spinal cord injury, possibly leading to bone density values below the fracture threshold with the risk of spontaneous fractures. This patient was admitted to hospital for multiple pressure sores requiring prolonged local dressings before and after plastic surgery performed in July 1995. In January 1996, following exercise, he developed a fracture of the femoral diaphysis with a cystic demineralized appearance of the bone. The etiologic work-up demonstrated hyperthyroidism due to iatrogenic iodine overload secondary to Betadine. A review of the literature revealed numerous cases of thyroid dysfunction secondary to iatrogenic iodine saturation. This case justifies regular surveillance of thyroid function tests during prolonged treatment with Betadine and identification of patients with a clinical predisposition.
Valayer-Chaleat
E
E
Service de Médecine Physique et Réadaptation, Hôpital Bellevue-CHU de Saint-Etienne, France.
Calmels
P
P
Giraux
P
P
Fayolle-Minon
I
I
D000287:Administration, Topical; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects; D005264:Femoral Fractures / Q000209:etiology* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D007049:Iatrogenic Disease; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000209:etiology; D010264:Paraplegia; D011206:Povidone-Iodine / Q000009:adverse effects*; D003668:Pressure Ulcer / Q000188:drug therapy*; D013119:Spinal Cord Injuries / Q000150:complications*
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine