Methimazole for Prevention of Iodinated Contrast Media–Induced Exacerbation of Thyrotoxicosis in Susceptible Patients
Authors' conclusion
In patients with pre-existing thyrotoxicosis treated with antithyroid drugs, MMI therapy before ICM exposure prevented exacerbations. In patients with low TSH levels before admission, increasing the dose of MMI before exposure led to improvement in thyroid functions after discharge.
Study context
- Population
- Patients aged ≥18 years admitted to a tertiary medical center who underwent ICM examination or procedure and received MMI prior to iodine exposure; mean age 72.3 ± 13.5 years, 64% female; 99% history of thyroid disease, 91% on MMI before admission179 patients · 202 hospitalizations
- Participants
- 75 / 110 / 15
- Exposure
- Low thyroid-stimulating hormone (TSH) vs Normal TSH vs High TSH
- Low TSHn = 75
- Normal TSHn = 110
- High TSHn = 15
- Outcome
- Thyroid function after discharge with MMI before ICM exposure
- Follow-up
- After discharge
Methodological detailssingle tertiary medical center
- Single tertiary medical center
Main finding
As reported in the abstract
- Low TSH: normalization of TSH after discharge
- 19%
- Low TSH: remained with low TSH after discharge
- 64%
- Low TSH: median difference in FT4
- −0.5 (IQR, −5.9 to 5.2) pmol/L
- Normal TSH: remained euthyroid after discharge
- 71%
- Normal TSH: low TSH after discharge
- 13%
- Normal TSH: high TSH after discharge
- 9%
- High TSH: TSH normalized
- 2 patients
- High TSH: remained with high TSH
- 47%
- High TSH: low TSH after discharge
- 27%
Observational data: associations, not effects.
Further findings
Low TSH with MMI dose increase during hospitalization (n = 8) · after discharge
- Median FT4 decrease
- −6.2 (IQR, −9.2 to −1) pmol/L
- Median TSH increase
- 0.2 (IQR, 0.02-0.7) mIU/L
Original publication
Methimazole for Prevention of Iodinated Contrast Media–Induced Exacerbation of Thyrotoxicosis in Susceptible Patients. Endocr Pract. Published 23 November 2024. doi:10.
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