title: Jod-Basedow effect due to prolonged use of lugol solution-case report.
abstract: Graves' disease is the most common form of hyperthyroidism, accounting for 60-80% of all cases of thyrotoxicosis. If left untreated, it may lead to severe thyrotoxicosis with cardiovascular, ocular, psychiatric complication, and in extreme cases thyrotoxic crisis with a high mortality rate. We present the case of a 50-years-old woman diagnosed in another service with Graves' disease and treated for many years with antithyroid drugs (ATDs), admitted to our service for a relapse due to treatment discontinuation. The surgical treatment was planned and the preoperative preparation with Lugol solution was initiated. Due to a misunderstanding, the administration of iodine solution was extended for a period of about 30 days, thus generating the so-called Jod-Basedow effect, with the exacerbation of the manifestations of thyrotoxicosis and risk of thyroid storm. The patient received treatment with high ATDs doses, glucocorticoids, and beta-blockers, resulting in the progressive improvement of symptoms. She was discharged from hospital and given the risk of thyrotoxic crisis the surgery was postponed. After a month, the patient underwent thyroidectomy without preoperative preparation with iodine solution. The operative and postoperative courses were uneventful.
authors.affiliation: University of Medicine and Pharmacy Grigore T. Popa - Iaşi, Department of Medical Specialties (II).
authors.forename: Letiţia
authors.initials: L
authors.lastname: Leuştean
authors.forename: Cristina
authors.initials: C
authors.lastname: Preda
authors.forename: Maria-Christina
authors.initials: MC
authors.lastname: Ungureanu
authors.forename: R
authors.initials: R
authors.lastname: Dănilă
authors.forename: Voichiţa
authors.initials: V
authors.lastname: Mogoş
authors.forename: Cipriana
authors.initials: C
authors.lastname: Stefănescu
authors.forename: Carmen
authors.initials: C
authors.lastname: Vulpoi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D013956:Antithyroid Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D007454:Iodides / Q000009:adverse effects*; D008875:Middle Aged; D011300:Preoperative Care; D013577:Syndrome; D013958:Thyroid Crisis / Q000139:chemically induced* / Q000188:drug therapy* / Q000601:surgery; D013965:Thyroidectomy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents; D005938:Glucocorticoids; D007454:Iodides; C010389:Lugol's solution