Iodine-induced hypothyroidism

被引:270
|
作者
Markou, K [1 ]
Georgopoulos, N [1 ]
Kyriazopoulou, V [1 ]
Vagenakis, AG [1 ]
机构
[1] Univ Patras, Sch Med, Dept Med, Div Endocrinol, Patras 26500, Greece
基金
美国国家卫生研究院;
关键词
D O I
10.1089/105072501300176462
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Iodine is an essential element for thyroid hormone synthesis. The thyroid gland has the capacity and holds the machinery to handle the iodine efficiently when the availability of iodine becomes scarce, as well as when iodine is available in excessive quantities. The latter situation is handled by the thyroid by acutely inhibiting the organification of iodine, the so-called acute Wolff-Chaikoff effect, by a mechanism not well understood 52 years after the original description. It is proposed that iodopeptide(s) are formed that temporarily inhibit thyroid peroxidase (TPO) mRNA and protein synthesis and, therefore, thyroglobulin iodinations. The Wolff-Chaikoff ef feet is an effective means of rejecting the large quantities of iodide and therefore preventing the thyroid from synthesizing large quantities of thyroid hormones. The acute Wolff-Chaikoff effect lasts for few a days and then, through the so-called "escape" phenomenon, the organification of intrathyroidal iodide resumes and the normal synthesis of thyroxine (T-4) and triiodothyronine (T-3) returns. This is achieved by decreasing the intrathyroidal inorganic iodine concentration by down regulation of the sodium iodine symporter (NIS) and therefore permits the TPO-H2O2 system to resume normal activity. However, in a few apparently normal individuals, in newborns and fetuses, in some patients with chronic systemic diseases, euthyroid patients with autoimmune thyroiditis, and Graves' disease patients previously treated with radioimmunoassay (RAI), surgery or antithyroid drugs, the escape from the inhibitory effect of large doses of iodides is not achieved and clinical or subclinical hypothyroidism ensues. Iodide-induced hypothyroidism has also been observed in patients with a history of postpartum thyroiditis, in euthyroid patients after a previous episode of subacute thyroiditis, and in patients treated with recombinant interferon-alpha who developed transient thyroid dysfunction during interferon-alpha treatment. The hypothyroidism is transient and thyroid function returns to normal in 2 to 3 weeks after iodide withdrawal, but transient T-4 replacement therapy may be required in some patients. The patients who develop transient iodine-induced hypothyroidism must be followed long term thereafter because many will develop permanent primary hypothyroidism.
引用
收藏
页码:501 / 510
页数:10
相关论文
共 50 条
  • [1] IODINE-INDUCED HYPOTHYROIDISM
    BEGG, TB
    HALL, R
    LANCET, 1963, 1 (729): : 1380 - &
  • [2] Iodine-induced hypothyroidism
    Wémeau, JL
    PRESSE MEDICALE, 2002, 31 (35): : 1670 - 1675
  • [3] IODINE-INDUCED HYPOTHYROIDISM FOLLOWING LYMPHOGRAPHY
    HEIDEMANN, P
    SCHURNBRAND, P
    STUBBE, P
    PRINDULL, G
    PEDIATRIC RESEARCH, 1981, 15 (12) : 1570 - 1570
  • [4] Iodine-induced hypothyroidism in the aging rat
    Theodoropoulos, T
    Vrioni, J
    GERONTOLOGIST, 2003, 43 : 3 - 4
  • [5] THYROID FUNCTION AND IODINE METABOLISM IN IODINE-INDUCED HYPOTHYROIDISM
    HARRISON, MT
    ALEXANDER, WD
    HARDEN, RMG
    LANCET, 1963, 1 (729): : 1238 - &
  • [6] IODINE-INDUCED HYPOTHYROIDISM DUE TO BENZIODARONE ( CARDIVIX )
    HARRISON, MT
    CAMERON, AJV
    BRITISH MEDICAL JOURNAL, 1965, 1 (5438): : 840 - &
  • [7] Iodine-induced hypothyroidism in a girl with anorexia nervosa
    Kita, Yusuke
    Mori, Jun
    Hosoi, Hajime
    PEDIATRICS INTERNATIONAL, 2019, 61 (05) : 528 - 529
  • [8] CONGENITAL RADIOACTIVE IODINE-INDUCED STRIDOR AND HYPOTHYROIDISM
    JAFEK, BW
    SMALL, R
    LILLIAN, DL
    ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 1974, 99 (05) : 369 - 371
  • [9] IODINE-INDUCED HYPOTHYROIDISM IN PATIENTS ON REGULAR DIALYSIS TREATMENT
    TAKEDA, S
    MICHIGISHI, T
    TAKAZAKURA, E
    NEPHRON, 1993, 65 (01): : 51 - 55
  • [10] SOME ASPECTS OF THYROIDAL IODINE METABOLISM IN A CASE OF IODINE-INDUCED HYPOTHYROIDISM
    PALEY, KR
    SOBEL, ES
    YALOW, RS
    JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1958, 18 (01): : 79 - 90