title: In the eye of the storm: iodinated contrast medium induced thyroid storm presenting as cardiopulmonary arrest.
abstract: The administration of iodinated contrast medium may lead to excess free thyroid hormone release and cause thyroid storm. A woman presented to the emergency department with dyspnea, hemoptysis, and intermittent bilateral lower extremities edema. Physical examination revealed mildly enlarged thyroid. Patient underwent a computed tomography scan of the chest with intravenous iodinated contrast medium to rule out pulmonary embolism, the patient developed a thyroid storm second to iodinated contrast medium injection. Proper treatment was provided and the patient had a good outcome. We present this case of an unusual presentation of a thyroid storm with cardiac arrest. This case illustrates that evaluating thyroid function tests in patients with an enlarged thyroid prior to the administration of iodinated contrast medium could prevent the development of thyroid storm.
authors.affiliation: Department of Medicine, Pocono Medical Center, The Commonwealth Medical College, East Stroudsburg, PA 18301 USA. alkhuja@yahoo.com
authors.forename: Samer
authors.initials: S
authors.lastname: Alkhuja
authors.forename: Ronald
authors.initials: R
authors.lastname: Pyram
authors.forename: Olutunde
authors.initials: O
authors.lastname: Odeyemi
mesh_terms: D003287:Contrast Media / Q000009:adverse effects*; D004417:Dyspnea / Q000000981:diagnostic imaging; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007472:Iohexol / Q000009:adverse effects*; D008168:Lung / Q000000981:diagnostic imaging; D008875:Middle Aged; D013958:Thyroid Crisis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: Acute respiratory failure; Cardiac arrest; Hyperthyroidism; Thyroid storm; Thyrotoxicosis