Thyroidectomy in iodine induced thyrotoxic storm.
Between January 1996 and September 1997 we treated 4 patients with iodine-induced thyrotoxic storm (2 females, 2 men; age 54-77 years). Iodine contamination was due to iodine-containing contrast media in 3 patients and iodine-containing disinfectant in 1 patient. Thyroid storm with tachycardia, hypertension, sweating, tremor, weight loss and coma occured 3-10 weeks after iodine contamination. These symptoms were accompanied by raised fT4- and fT3-values. All 4 patients were initially treated with antithyroid drugs for 7 days, whereas 2 patients with coronary artery disease, demonstrated by coronary angio-graphy, were treated with antithyroid drugs for 2 weeks. Because of unsuccessful antithyroid drug treatment, all 4 patients underwent subtotal thyroidectomy. There were no perioperative complications. We conclude that early thyroidectomy is the appropriate treatment for iodine-induced thyrotoxicosis even in patients with severe accompanying diseases.
Weber
C
C
Department of Medicine III, University of Leipzig, Germany.
Scholz
G H
GH
Lamesch
P
P
Paschke
R
R
D000368:Aged; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007455:Iodine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D013958:Thyroid Crisis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D013974:Thyroxine / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome
D013956:Antithyroid Agents; D007455:Iodine; D013974:Thyroxine