Iodinated contrast prior to evaluation for thyrotoxicosis.
BACKGROUND
Radioactive iodine is useful in the diagnosis and treatment of patients with newly diagnosed thyrotoxicosis. However, in many patients these tests are not possible to obtain due to recent administration of iodinated contrast for other types of diagnostic studies, most frequently computed tomography (CT) scans.


OBJECTIVE
To determine the frequency of iodinated contrast use in hospital inpatients newly diagnosed with thyrotoxicosis and the utility of these studies.


METHODS
Retrospective chart review.


METHODS
Academic medical center.


METHODS
None.


METHODS
Inpatients with newly diagnosed thyrotoxicosis who were seen in consultation by the endocrinology service.


METHODS
The records of inpatient endocrinology consultations (n = 1171) performed by our service over a 4-year period were reviewed. Records of patients with newly diagnosed thyrotoxicosis were identified and reviewed to determine if iodinated contrast had been recently administered, the types of studies it was used for, and the results of those studies.


RESULTS
Forty-five patients (45%) had been given iodinated contrast within 2 weeks prior to endocrinology evaluation, 43 for CT scanning, and 2 for angiography. Of the patients who underwent CT scanning, 7 (16%) had a finding that potentially changed their inpatient management. Only 1 of these patients required emergent treatment of a condition diagnosed by CT scan before further diagnostic studies could have been performed.


CONCLUSIONS
A substantial number of inpatients with thyrotoxicosis receive iodinated contrast prior to endocrinologic evaluation. Acute findings from these studies that change patient management are uncommon. Awareness of this issue may facilitate care of hospitalized patients with thyrotoxicosis.
Phillips
Brian D
BD
Division of Endocrinology, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA.
Hennessey
James V
JV
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013971:Thyrotoxicosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014055:Tomography, Emission-Computed / Q000706:statistics & numerical data*; D055815:Young Adult
D007457:Iodine Radioisotopes