| Autor: |
Bednarczuk T; Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland., Kajdaniuk D; Chair of Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland. dkajdaniuk@sum.edu.pl., Marek B; Chair of Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland., Bolanowski M; Chair and Department of Endocrinology, Diabetes, and Isotope Therapy, Medical University of Wroclaw, Wroclaw, Poland., Dedecjus M; Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland., Gilis-Januszewska A; Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland., Hubalewska-Dydejczyk A; Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland., Jarząb B; Nuclear Medicine and Endocrine Oncology Department, M. Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland., Junik R; Department of Endocrinology and Diabetology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland., Kamiński G; Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine - National Research Institute, Warsaw, Poland., Kos-Kudła B; Chair of Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland., Kowalska A; Department of Endocrinology, Holycross Cancer Centre, Collegium Medicum, Jan Kochanowski University, Kielce, Poland., Lewiński A; Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland., Matyjaszek-Matuszek B; Chair and Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Lublin, Poland., Ruchała M; Department of Endocrinology, Metabolism and Internal Medicine, Medical University in Poznan, Poznan, Poland., Siemińska L; Chair of Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland., Sworczak K; Chair and Department of Endocrinology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland., Syrenicz A; Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University, Szczecin, Poland., Zgliczyński W; Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland. |
| Abstrakt: |
Medical practice involves a high number of radiological examinations using iodinated contrast media (ICM). Therefore, it is crucial for doctors of different specialties to be aware of possible adverse effects associated with ICM use. The most common and well characterized adverse effect is contrast-induced nephropathy, whereas thyroidal adverse reactions remain a diagnostic and therapeutic dilemma. ICM-induced thyroid dysfunction represents a highly heterogenous group of thyroid disorders. Due to supraphysiological iodine concentration, ICM can induce both hyper- and hypothyroidism. In most cases, the ICM-induced thyroid dysfunction is oligo- or asymptomatic, mild, and transient. In rare cases, however, the ICM-induced thyroid dysfunction may be severe and life threatening. Recently, the European Thyroid Association (ETA) Guidelines for the Management of Iodine-Based Contrast Media-Induced Thyroid Dysfunction were published. The authors advise an individualized approach to prevention and treatment of ICM-induced thyroid dysfunction, based on patient's age, clinical symptoms, pre-existing thyroid diseases, coexisting morbidities, and iodine intake. There is a geographic variation of ICM-induced thyroid dysfunction prevalence, which is linked to iodine intake. The prevalence of ICM-induced hyperthyroidism, which may pose a serious therapeutic challenge, is greater in countries with iodine deficiency. Poland is a region with a history of iodine deficiency, contributing to an increased prevalence of nodular thyroid disease, especially in the elderly. Therefore, the Polish Society of Endocrinology has proposed national, simplified principles of ICM-induced thyroid dysfunction prevention and treatment. |
