Thomas Abin, Varghese Jerin, Trikkur Sreekrishnan, Kumar Gireesh
Department of Emergency Medicine, Amrita Institute of Medical Sciences and Research Center, Kochi, IND.
Cureus. 2025 May 5;17(5):e83544. doi: 10.7759/cureus.83544. eCollection 2025 May.
Jod-Basedow phenomenon (JBP) is an alternative term for iodine-induced thyrotoxicosis, which is a rare hyperthyroid illness that is brought on by excessive iodine exposure. Patients with underlying thyroid conditions, autoimmune diseases, or chronic renal disease are populations frequently affected by the JBP. The potential for this disorder to circumvent normal thyroid autoregulation and result in potentially fatal consequences makes it especially worrying. Here, we describe the case of a 50-year-old woman who had a known case of dyslipidemia, cardiomyopathy, and type 2 diabetes and presented to the emergency department with complaints of nausea and stomach pain. Diabetic ketoacidosis (DKA) was suspected based on venous blood gas reports that showed significant anion gap metabolic acidosis. Imaging revealed characteristics indicative of thyroiditis, and additional testing verified hyperthyroidism. Interestingly, the patient had only had iodinated contrast medium coronary angiography one day before presentation to the emergency department. This case highlights the underdiagnosed yet severe risk of iodine-induced thyroid dysfunction, particularly in patients with silent thyroid disease, which can precipitate acute conditions such as DKA.
碘致甲亢现象（JBP）是碘诱发甲状腺毒症的另一种说法，它是一种罕见的甲状腺功能亢进疾病，由碘摄入过量引起。患有潜在甲状腺疾病、自身免疫性疾病或慢性肾病的患者是经常受JBP影响的人群。这种疾病有可能规避正常的甲状腺自身调节并导致潜在的致命后果，这使其格外令人担忧。在此，我们描述一名50岁女性的病例，她已知患有血脂异常、心肌病和2型糖尿病，因恶心和胃痛到急诊科就诊。根据静脉血气报告显示存在显著阴离子间隙代谢性酸中毒，怀疑为糖尿病酮症酸中毒（DKA）。影像学检查显示出甲状腺炎的特征，进一步检查证实存在甲状腺功能亢进。有趣的是，该患者在到急诊科就诊前一天仅进行了碘造影剂冠状动脉造影。该病例突出了碘诱发甲状腺功能障碍诊断不足但风险严重的问题，尤其是在患有隐匿性甲状腺疾病的患者中，这种疾病可能引发如DKA等急性病症。
