Iodinated Contrast Media-Induced Thyroid Dysfunction in Euthyroid Nodular Goiter Patients.
The risks of thyroid dysfunction after iodinated contrast media exposure in patients with euthyroid nodular goiter are largely unknown.



This observational, retrospective cohort study included a random selection of one million people in Taiwan. All patients with iodinated contrast media exposure during this study period were selected. Patients with euthyroid nodular goiter were identified as cases, while patients without thyroid nodule were selected as controls. We followed these patients until the first event of thyroid dysfunction including hyperthyroidism or hypothyroidism after iodinated contrast media exposure.



A total of 334 cases and 2672 matched controls were selected in this study. The mean age of cases and controls were 58.6 and 58.4 years old, and mean follow-up durations were 2.1 and 2 years respectively. After adjustment, patients with euthyroid nodular goiter had a higher risk of thyroid dysfunction (hazard ratio 5.43, [confidence interval (CI) 3.01-9.80]) compared with controls after iodinated contrast media exposure. In the subgroup analysis, the risks of hyperthyroidism and hypothyroidism in cases compared with controls were 5.77 [CI 2.64-12.62] and 4.95 [CI 2.15-11.40] respectively. Half of the euthyroid nodular goiter cases developed thyroid dysfunction within one year after iodinated contrast media exposure. Interestingly, all thyroid-related comorbidities and drug prescriptions did not increase the risk of thyroid dysfunction.



Presence of euthyroid nodular goiter was associated with higher risk of thyroid dysfunction including hyperthyroidism and hypothyroidism after iodinated contrast media exposure.
1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital , Taichung, Taiwan .|2 Institute of Medicine of Chung Shan Medical University , Taichung, Taiwan .
Edy
E
Kornelius
3 School of Health Policy and Management, Institute of Medicine of Chung Shan Medical University , Taichung, Taiwan .
Jeng-Yuan
JY
Chiou
1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital , Taichung, Taiwan .|2 Institute of Medicine of Chung Shan Medical University , Taichung, Taiwan .
Yi-Sun
YS
Yang
1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital , Taichung, Taiwan .
Shih-Chang
SC
Lo
4 Division of Basic Medical Research, Hung Kuang University , Taichung, Taiwan .
Chiung-Huei
CH
Peng
5 Pharmacy, Chung Shan Medical University Hospital , Taichung, Taiwan .
Yung-Rung
YR
Lai
1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital , Taichung, Taiwan .|2 Institute of Medicine of Chung Shan Medical University , Taichung, Taiwan .
Chien-Ning
CN
Huang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging*; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced* / Q000503:physiopathology; D007037:Hypothyroidism / Q000139:chemically induced* / Q000503:physiopathology; D007455:Iodine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013961:Thyroid Gland / Q000503:physiopathology
D003287:Contrast Media; D007455:Iodine