Incidence of Iodine-induced Hyperthyroidism after Administration of Iodinated Contrast during Radiographic Procedures: A Systematic Review and Meta-analysis of the Literature.

Bervini, Sandrina; Trelle, Sven; Kopp, Peter A; Stettler, Christoph; Trepp, Roman (2021). Incidence of Iodine-induced Hyperthyroidism after Administration of Iodinated Contrast during Radiographic Procedures: A Systematic Review and Meta-analysis of the Literature. Thyroid, 31(7), pp. 1020-1029. Mary Ann Liebert 10.1089/thy.2020.0459

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BACKGROUND

Iodine-induced hyperthyroidism (IIH) was a common issue in the early twentieth century after introduction of iodine supplementation in dietary salt. Currently, iodine induced hyperthyroidism (IIH) is mostly encountered in Western countries as a consequence of radiographic procedures involving the administration of iodinated contrast media (ICM). However, little is known about the magnitude and clinical relevance of this issue. To assess the incidence of hyperthyroidism after ICM exposure, we performed a systematic review and meta-analysis of the literature.

METHODS

MEDLINE, Embase and the Cochrane Library were systematically searched for trials published between 1946 and May 2018. Studies were considered eligible if they investigated the association between hyperthyroidism and iodinated contrast. Data on study design, baseline characteristics and outcomes were extracted independently by two reviewers.

RESULTS

Thirty out of 1493 retrieved studies were included in the analysis. The time endpoint to assess thyroid hormone levels after ICM exposure varied between 1-541 days among studies, with most studies having a time endpoint between 7-56 days. The overall estimated prevalence of overt hyperthyroidism after ICM exposure was extremely low (0.1%, 95% CI 0-0.6%), and did not change after adjustments for baseline thyroid status (0.3% in euthyroid patients at baseline, 95% CI 0-1.7%). There were no cases with overt hyperthyroidism at 7 days after ICM exposure, and the incidence was very low at 30 days (0.2%, 95% CI 0-0.8%).

CONCLUSION

The incidence of IIH following ICM administration during radiographic procedures is extremely low.

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