Papadopoulos Panagiotis, Iordanou Stelios, Georgiou Fotini, Kalifatidis Dimitris, Herodotou Elena, Timiliotou-Matsentidou Chrystalla
Intensive Care Unit, Limassol General Hospital, State Health Services Organisation (SHSO), Limassol, CYP.
Cureus. 2022 Apr 11;14(4):e24034. doi: 10.7759/cureus.24034. eCollection 2022 Apr.
Povidone-iodine (PI) is considered a generally safe broad-spectrum, antiseptic substance, which is widely used in healthcare services, mostly for burn patients, in wound treatment, surgical wound irrigation, as well as for a few gynecological indications. Although it is safe, its use on mucosa can cause toxicity due to iodine absorption and the high concentration in the serum. PI toxicity is absorption depended and has been associated with severe adverse events including acute kidney injury (AKI). To our knowledge, there are only three cases of PI-induced AKI after uterine instillation in the published literature. We report a case of severe PI-induced AKI that occurred in a 23-year-old female due to iodine systemic absorption immediately post uterine instillation, in terms of infertility evaluation. The patient was admitted to the intensive care unit (ICU), supported with mechanical ventilation and treated with renal replacement therapy (RRT). Renal function and urine output improved and the patient was discharged from ICU. Severe adverse events may be linked to internal use, therefore, PI on mucosa should be used with extreme caution. Clinicians should be aware of iodine intoxication and possible AKI.
聚维酮碘（PI）被认为是一种普遍安全的广谱抗菌物质，广泛应用于医疗服务中，主要用于烧伤患者、伤口治疗、外科伤口冲洗以及一些妇科适应症。尽管它是安全的，但在黏膜上使用时，由于碘的吸收和血清中的高浓度，可能会导致毒性。PI毒性取决于吸收情况，并与包括急性肾损伤（AKI）在内的严重不良事件有关。据我们所知，在已发表的文献中，仅有3例子宫内灌注PI后导致AKI的病例。我们报告了一例23岁女性因子宫内灌注后碘的全身吸收导致严重PI诱导的AKI病例，该病例是在不孕症评估过程中发生的。患者被收入重症监护病房（ICU），接受机械通气支持并接受肾脏替代治疗（RRT）。肾功能和尿量有所改善，患者从ICU出院。严重不良事件可能与内用有关，因此，PI在黏膜上的使用应极其谨慎。临床医生应意识到碘中毒和可能的AKI。
