povidone-iodine and Hyperthyroidism

Iodine-induced hyperthyroidism and triiodothyronine (T3) thyrotoxicosis in patients who routinely gargle with povidone-iodine (PVP-I) gargling solution are rare in Japan.. A 50-year-old man presented to our hospital for a close examination of an enlarged thyroid, which was noted during a complete health checkup. The thyroid was slightly enlarged with no palpable nodules. He had an increased appetite but no weight gain. He had been routinely gargling with PVP-I gargling solution 4 times daily for >10 years. He had no history of thyroid disease.. Test results revealed suppressed thyroid-stimulating hormone, normal free thyroxine, and increased free triiodothyronine levels, leading to the diagnosis of T3 thyrotoxicosis.. The patient agreed to stop gargling with PVP-I gargle solution.. The free triiodothyronine and thyroid-stimulating hormone levels returned to normal at 18 and 21 weeks, respectively, after discontinuation of PVP-I gargling. After an improvement in thyroid function, he gained 5 kg in 1 year.. To our knowledge, this is the first case report that describes PVP-I gargle-induced T3 thyrotoxicosis in a healthy individual without thyroid disease. In Japan, which is an iodine-sufficient country, considering the possibility of high-dose iodine intake-induced thyrotoxicosis due to long-term PVP-I gargling or other causes is necessary, even in individuals with no history of thyroid disease.

Topics: East Asian People; Humans; Hyperthyroidism; Iodine; Male; Middle Aged; Mouthwashes; Povidone-Iodine; Thyrotoxicosis; Triiodothyronine

Topics: Administration, Topical; Adult; Anti-Infective Agents, Local; Cachexia; Chlorhexidine; Critical Care; Drug Substitution; Foot Ulcer; Humans; Hyperthyroidism; Ischemia; Male; Nephrectomy; Norepinephrine; Postoperative Complications; Povidone-Iodine

Till now there has not been reported data related to the influence of leflunomide on the thyroid gland function of the treated person. The authors described the case of woman with rheumathoid arthritis and hypothyroidism who revealed hyperthyroidism in 7 months after starting leflunomide tablets treatment containing povidone iodine as well. Also both autonomical tissue area in thyroid right lobe and hight TSHRAb level were found. Leflunomid tablets containing povidone iodine in its structure can cause hyperthyroidism in the person with previous hypothyroidism and nodular goiter, probably as a result of immunological reconversion and tissue nodular functional autonomisation. In persons with nodular goitre one should prefer free of povidone iodine leflunomide treatment and also monitor serum thyroid hormone contents and thyroid antibodies as well.

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Drug Combinations; Female; Humans; Hyperthyroidism; Hypothyroidism; Isoxazoles; Leflunomide; Middle Aged; Povidone-Iodine

Topics: Anti-Infective Agents, Local; Bandages; Electroencephalography; Humans; Hydrocarbons, Iodinated; Hyperthyroidism; Magnetic Resonance Imaging; Male; Middle Aged; Nervous System Diseases; Povidone-Iodine; Shock, Septic; Thyrotropin; Thyroxine

Post pneumonectomy infection is a well-described surgical complication. Treatment usually involves thoracostomy and requires local treatments. We report here an unusual complication of this situation.. A 62 year old man had a pneumonectomy for non-small cell lung cancer. Following this he required a thoracostomy to treat a thoracic empyema and this was treated with local anti-septic agents. Subsequently he developed asthenia and a diagnosis of hyperthyroidism was made secondary to local disinfectant treatment with iodine agents.. We describe an original case of thyroxicosis occurring in a patient following treatment for post-pneumonectomy empyema. We would recommend monitoring thyroid function in this context.

Topics: Anti-Infective Agents, Local; Asthenia; Empyema, Pleural; Humans; Hyperthyroidism; Male; Middle Aged; Pneumonectomy; Povidone-Iodine; Thoracostomy

Analysis of the clinical case of a male aged 30 years, presenting with T6 complete paraplegia in 1991, demonstrated the existence of aggravating factors for disuse osteoporosis of spinal cord injury, possibly leading to bone density values below the fracture threshold with the risk of spontaneous fractures. This patient was admitted to hospital for multiple pressure sores requiring prolonged local dressings before and after plastic surgery performed in July 1995. In January 1996, following exercise, he developed a fracture of the femoral diaphysis with a cystic demineralized appearance of the bone. The etiologic work-up demonstrated hyperthyroidism due to iatrogenic iodine overload secondary to Betadine. A review of the literature revealed numerous cases of thyroid dysfunction secondary to iatrogenic iodine saturation. This case justifies regular surveillance of thyroid function tests during prolonged treatment with Betadine and identification of patients with a clinical predisposition.

Topics: Administration, Topical; Adult; Anti-Infective Agents, Local; Bone Density; Femoral Fractures; Fracture Fixation, Intramedullary; Humans; Hyperthyroidism; Iatrogenic Disease; Male; Osteoporosis; Paraplegia; Povidone-Iodine; Pressure Ulcer; Spinal Cord Injuries

Povidone-iodine (PVP-I) is generally very safe, but cases of thyroid dysfunction induced by PVP-I have been reported. The effect of long-term treatment with PVP-I on thyroid function was to be assessed. In 40 inpatients of the department of neurology, the status of the use of PVP-I preparations and their effects on serum inorganic iodine levels and thyroid functions were investigated. In 27 patients treated with PVP-I for a long term, inorganic iodine levels were significantly increased as compared to those in 13 patients without PVP-I treatment. Out of 27 patients treated with PVP-I in the long term, subclinical hypothroidism was seen in 3 patients, mild hyperthroidism was seen in 1 patient, and subclinical hyperthyroidism was suspected in 7 patients. Patients treated with PVP-I for a long time should be observed carefully for any manifestation of thyroid dysfunction.

Topics: Amyotrophic Lateral Sclerosis; Anti-Infective Agents, Local; Catheterization, Central Venous; Female; Gastrostomy; Humans; Hyperthyroidism; Hypothyroidism; Iodine; Iodophors; Longitudinal Studies; Male; Middle Aged; Nasal Mucosa; Parenteral Nutrition; Povidone-Iodine; Safety; Skin Ulcer; Spinocerebellar Degenerations; Thyroid Gland; Thyrotropin; Thyroxine; Tracheotomy; Triiodothyronine; Urethra

Topics: Humans; Hyperthyroidism; Infant, Newborn; Male; Mediastinitis; Povidone-Iodine; Therapeutic Irrigation

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Humans; Hyperthyroidism; Male; Povidone-Iodine

Iodine is known as a local disinfectant substance for more than 100 years. Its use however was restricted due to strong local irritation. In the last 25 years Polyvinylpyrrolidon-Iodine solutions (Povidone-Iodine, PVP-Iodine, Betadine) has become more and more popular for treating traumatologic, surgical and orthopaedic infections. However several papers have reported changes in the blood chemistry (T3, T4, TSH, PBJ and Iodine excretion in the urine) after utilizing PVP-Iodine, especially in visceral surgery. We report on a patient in whom a massive iodine resorption with clinical signs of hyperthyroidism occurred, with soft tissue necrosis at the site of irrigation.

Topics: Adult; Amputation, Traumatic; Humans; Hyperthyroidism; Knee Injuries; Male; Postoperative Complications; Povidone-Iodine; Reoperation; Staphylococcal Infections; Streptococcal Infections; Suction; Surgical Wound Infection; Therapeutic Irrigation

Hyperthyroidism was induced in two burn patients (one a 34-year-old male, with burns covering 80 per cent BSA and the other a 22-year-old female with a 45 per cent BSA burn) by topical treatment with povidone-iodine. Both patients had no history of thyroid disease and their post-burn examination revealed normal thyroid glands. In both patients 1 per cent povidone-iodine was applied onto granulation tissue and a marked increase in circulating thyroid hormones occurred. After topical treatment with povidone-iodine was discontinued circulating thyroid hormones returned to normal values within weeks. In the second patient povidone-iodine treatment had to be repeated again resulting in hyperthyroidism which was also readily reversible.

Topics: Administration, Topical; Adult; Burns; Female; Humans; Hyperthyroidism; Male; Methimazole; Povidone; Povidone-Iodine; Thyroid Hormones

In a 63-year-old woman with a multinodular goiter who was receiving suppressive therapy with levothyroxine sodium, iodine-induced thyrotoxicosis developed after povidone-iodine was applied to the surface of a granulating hip wound. Signs and symptoms of apathetic thyrotoxicosis developed on two occasions, once within a week after exposure of the wound to povidone-iodine soaks and again following repeated Hubbard tank debridement with added povidone-iodine. Iodine-induced thyrotoxicosis was confirmed by markedly elevated serum thyroxine and serum and urine iodine levels. On eliminating the sources of exogenous iodine and inhibiting thyroxine biosynthesis with propylthiouracil, the process was gradually controlled. A year later the patient was taking no medication and was clinically and chemically euthyroid. Apparently, iodine-induced thyrotoxicosis can result from passive diffusion of iodine into autonomous thyroid tissue. Iodine-containing preparations given to patients with multinodular goiters may result in thyrotoxicosis even if thyrotropin is suppressed with exogenous thyroxine.

Topics: Female; Goiter, Nodular; Humans; Hyperthyroidism; Iodine; Middle Aged; Povidone-Iodine; Thyroxine

Iodine-induced hyperthyroidism has been frequently described when iodine is introduced into an iodine-deficient area. However, it may also occur in patients with and without previous thyroid disease residing in iodine-sufficient areas. Five patients with iodine-induced hyperthyroidism seen in a 12-month period are described. All were exposed to iodine in the form of commonly used drugs (Betadine, Iodo-Niacin, amiodarone, and radiographic contrast dyes). The cause of iodine-induced hyperthyroidism is unclear, but it is probably more common in patients with goiters containing previously existing areas of autonomous function or iodine-poor thyroglobulin. Iodine-induced hyperthyroidism usually abates after iodine withdrawal in patients with multinodular goiters or normal thyroid glands. The hyperthyroidism is usually treated with beta-blockers and antithyroid thionamide drugs, although reinstitution of iodine to block thyroid hormone release or corticosteroids occasionally may be necessary. Iodine-containing drugs should be given with caution to patients with underlying thyroid disease.

Topics: Adult; Amiodarone; Chlorobutanol; Coloring Agents; Coronary Artery Bypass; Drug Combinations; Female; Goiter, Nodular; Graves Disease; Humans; Hyperthyroidism; Iodine; Iodine Radioisotopes; Male; Middle Aged; Niacinamide; Postoperative Complications; Povidone-Iodine; Propylthiouracil; Radiographic Image Enhancement; Sodium Iodide; Thyroid Hormones

Topics: Amiodarone; Goiter; Humans; Hyperthyroidism; Iodine; Ophthalmic Solutions; Povidone-Iodine

Topics: Adult; Female; Humans; Hyperthyroidism; Iodine; Povidone-Iodine; Vagina

Topics: General Surgery; Humans; Hyperthyroidism; Iodine; Nurses; Povidone; Povidone-Iodine; Preoperative Care; Skin Absorption

Topics: Humans; Hyperthyroidism; Iodine Isotopes; Povidone-Iodine