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Alterations in Thyroid Function After Cholecystographic Contrast Agents
Author(s) -
Hunter A. N.,
Meinhold H.,
Stockigt J. R.
Publication year - 1982
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1982.tb02459.x
Subject(s) - medicine , contrast (vision) , thyroid function , thyroid , thyroid function tests , function (biology) , artificial intelligence , evolutionary biology , computer science , biology
Abstract:Alterations in thyroid function after cholecystographic contrast agents . A. N. Hunter, H. Meinhold and J. R. Stockigt, Aust. N.Z. J. Med., 1982, 12, pp. 192–195. The radiographic contrast agents commonly used for oral cholecystography have diverse effects on thyroid hormones in man. They may: (i) decrease serum triiodothyronine (T 3 ) and increase reverse T 3 in both hyperthyroid and euthyroid subjects, an effect attributable to inhibition of phenolic (outer) ring deiodination of iodothyronines; (ii) acutely increase serum thyroxine (T 4 ) by displacing it from the liver, so inviting an erroneous diagnosis of hyperthyroidism; (iii) precipitate hyperthyroidism in apparently euthyroid subjects who have autonomous thyroid tissue. In comparison with the cholecystographic agents which are taken up by the liver, the renally–excreted contrast agents used for angiography or intravenous urography are much less potent in producing these effects. The paradox of T 4 excess with normal T 3 may arise after cholecystography, either by an acute T“ 4 increase in a euthyroid subject, or by normalization of T 3 in hyperthyroidism, thus creating a diagnostic dilemma. The recent trend towards use of oral cholecystographic agents in the urgent management of hyperthyroidism, because of their effect on serum T 3 , needs to be regarded with caution in view of the risk that hyperthyroidism may eventually be worsened if synthesis of T A is not effectively blocked. For this reason, contrast media should probably be used in the treatment of hyperthyroidism only in conjunction with conventional antithyroid drugs. A history of exposure to contrast media should be sought in any acute or unexpected exacerbation of hyperthyroidism, or when T 4 excess is found without an increase in T 3 .