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: Samer Alkhuja, Ronald Pyram, Olutunde Odeyemi
• Journal: Heart & lung : the journal of critical care (Heart Lung) 2013 Jul-Aug Vol. 42 Issue 4 Pg. 267-9 ISSN: 1527-3288 [Electronic] United States
• PMID: 23711892 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Contrast Media
• Iohexol

Topics

• Contrast Media (adverse effects)
• Dyspnea (diagnostic imaging)
• Female
• Heart Arrest (etiology)
• Humans
• Iohexol (adverse effects)
• Lung (diagnostic imaging)
• Middle Aged
• Thyroid Crisis (chemically induced, complications, diagnosis, therapy)
• Tomography, X-Ray Computed