RECTAL ADMINISTRATION OF IODIDE AND PROPYLTHIOURACIL IN THE TREATMENTOF THYROID STORM

We administered potassium iodide and propylthiouracil per rectum, in c onjunction with intravenous dexamethasone and propranolol, for emergen t treatment of a patient in thyroid storm with small bowel obstruction , Shortly after initiation of this treatment, the patient successfully underwent two emergent surgical procedures for resection of an intest inal volvulus with advanced peritonitis, Serum levels of iodide and pr opylthiouracil showed substantial absorption of these drugs via the re ctal route, Measurement of 24-h urinary-free iodide indicated that the bioavailability of potassium iodide delivered by retention enema was at least 40%, Parenteral iodide preparations have been unavailable in the past, and continue to be difficult to obtain emergently. Rectal ad ministration of inorganic iodide is an effective, readily available an d less expensive alternative to parenteral sodium iodide for patients in thyroid storm with upper gastrointestinal tract dysfunction.