title: Hyperthyroidism secondary to hysterosalpingography: an extremely rare complication: A case report.
abstract: BACKGROUND
  Hysterosalpingography (HSG), a standard procedure for the evaluation of women with infertility and repetitive pregnancy loss, is associated with complications such as uterine perforation, infection, allergic reactions, syncope, hemorrhage and shock, and pulmonary or retinal embolus. However, hyperthyroidism has not been reported as one of its complications.
  
  
  METHODS
  We report the case of a 33-year-old euthyroid woman who presented to our hospital with palpitation, hand tremor, fatigue, and excessive sweating after HSG. Thyroid function tests revealed a thyroid stimulating hormone (TSH) level of 0.012 μIU/mL (range 0.38-4.34 μIU/mL), free T4 of 2.886 ng/dL (range 0.81-1.89 ng/dL), and free T3 levels of 9.4 pg/mL (range 1.80-4.10 pg/mL), and antithyroglobulin antibody of 31.78 IU/mL (range <115 IU/mL). The triiodothyronine uptake was 3.057 ng/mL (range 0.66-1.92 ng/mL). Serum iodine (SI) and urinary iodine (UI) levels: SI of 4717.748 μg/L (range 45-90 μg/L) and UI of 18069.336 μg/L (range 26-705 μg/L).
  
  
  RESULTS
  The patient was diagnosed with iodine-induced hyperthyroidism (IIH), but was not treated with antithyroid drugs. She has spontaneously recovered and is pregnant currently.
  
  
  CONCLUSIONS
  This is the first reported case of overt IIH caused by HSG in a euthyroid patient without risk factors. It suggests that HSG also leads to excessive iodine absorption, which induces secondary hyperthyroidism.
authors.affiliation: Department of Cardiac Surgery, Peking Union Medical College Hospital, Beijing, China Department of Plastic Surgery, Plastic Surgery Hospital (Institute), Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Beijing, China.
authors.forename: Guotao
authors.initials: G
authors.lastname: Ma
authors.forename: Rui
authors.initials: R
authors.lastname: Mao
authors.forename: Haixin
authors.initials: H
authors.lastname: Zhai
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000008:administration & dosage; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D007047:Hysterosalpingography / Q000009:adverse effects* / Q000379:methods; D007247:Infertility, Female / Q000175:diagnosis; D007455:Iodine / Q000009:adverse effects*; D011247:Pregnancy; D035583:Rare Diseases; D018570:Risk Assessment
chemical_list: D013956:Antithyroid Agents; D003287:Contrast Media; D007455:Iodine