Zhang Shi-Chang, Yan Cheng-Jing, Li Yun-Fei, Cui Ting, Shen Mei-Ping, Zhang Jie-Xin
Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
World J Clin Cases. 2022 Oct 26;10(30):11010-11015. doi: 10.12998/wjcc.v10.i30.11010.
This is the first documentation of a spontaneous and nonspecific chemical reaction of an iodinated contrast media with ammonium persulfate used in As-Ce catalytic spectrophotometry for urine iodine concentration (UIC) detection.
We herein report an incidental case who had a dual source computed tomography examination for papillary thyroid carcinoma diagnosis. Serial spot urine specimens were collected during her hospitalization and were measured by As-Ce catalytic spectrophotometry on a Beckman Coulter AU5800. The reacted solutions were "brownish", and the results showed extremely high iodine concentrations despite serial dilutions. The patient claimed no dietary habit of iodized salt or iodine-containing medical history, which strongly pointed to iodinated contrast media (ICM) intravenous injection. Even with 0.01% ICM, its interruption is still profound on the desired urine iodine reaction with ammonium persulfate, leading to inaccurate UIC and possibly inappropriate treatment.
The following laboratory suggestions should be considered: (1) As-Ce catalytic spectrophotometry is only suitable for UIC measurement after confirmed ICM renal clearance; (2) A mass spectrometry-based method can be applied as an alternative during the ICM clearance period; and (3) The UIC baseline can be confirmed after ICM injection by consecutive detection for at least 2 mo.
这是关于碘化造影剂与过硫酸铵在用于尿碘浓度（UIC）检测的砷铈催化分光光度法中发生自发且非特异性化学反应的首次记录。
我们在此报告一例因诊断甲状腺乳头状癌而进行双源计算机断层扫描检查的偶然病例。在其住院期间收集了系列随机尿标本，并在贝克曼库尔特AU5800上用砷铈催化分光光度法进行测量。反应后的溶液呈“褐色”，尽管进行了系列稀释，但结果显示碘浓度极高。患者称无食用加碘盐的饮食习惯或含碘病史，这强烈提示为静脉注射了碘化造影剂（ICM）。即使是0.01%的ICM，其对尿碘与过硫酸铵的预期反应的干扰仍然很大，导致UIC不准确并可能造成不适当的治疗。
应考虑以下实验室建议：（1）砷铈催化分光光度法仅适用于确认ICM经肾清除后的UIC测量；（2）在ICM清除期间可应用基于质谱的方法作为替代；（3）在注射ICM后通过连续检测至少2个月来确认UIC基线。
