povidone-iodine and Thyrotoxicosis

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

We describe an elderly man who was admitted with congestive cardiac failure and found to have thyrotoxicosis. He did not have goiter, and he had normal radioiodine uptake in his neck. Serum iodine levels were elevated, explaining the lack of increase in radioiodine uptake in the thyroid gland. He had multiple pressure sores, which were treated with povidone-iodine (Betadine) soaks. Biochemical data were consistent with Graves' disease unmasked by topical iodine application. Povidone-iodine soaks are commonly used in decubitus ulcer care and warrant special attention in patients with preexisting thyroid disorders. We have reviewed the literature on this unusual complication.

Topics: Administration, Topical; Aged; Graves Disease; Heart Failure; Humans; Male; Povidone-Iodine; Pressure Ulcer; Thyrotoxicosis

Topics: Anti-Infective Agents, Local; Diagnosis, Differential; Female; Humans; Iodine Radioisotopes; Middle Aged; Paraplegia; Povidone-Iodine; Tachycardia; Thyroid Gland; Thyrotoxicosis; Thyroxine; Triiodothyronine; Urinary Catheterization

Topics: Burns; Humans; Infant; Intensive Care Units, Pediatric; Male; Povidone-Iodine; Thyroid Function Tests; Thyrotoxicosis

Topics: Humans; Iodine Radioisotopes; Povidone-Iodine; Thyrotoxicosis