Thyroidectomy in iodine induced thyrotoxic storm

Between January 1996 and September 1997 we treated 4 patients with iodine-i nduced thyrotoxic storm (2 females, 2 men; age 54-77 years). Iodine contami nation was due to iodine-containing contrast media in 3 patients and iodine -containing disinfectant in 1 patient. Thyroid storm with tachycardia, hypertension, sweating, tremor, weight loss and coma occured 3-10 weeks after iodine contamination. These symptoms wer e accompanied by raised fT(4)- and fT(3)-values. All 4 patients were initially treated with antithyroid drugs for 7 days, wh ereas 2 patients with coronary artery disease, demonstrated by coronary ang io-graphy, were treated with antithyroid drugs for 2 weeks Because of unsuc cessful antithyroid drug treatment, all 3 patients underwent subtotal thyro idectomy. There were no perioperative complications. We conclude that early thyroidectomy is the appropriate treatment for iodin e-induced thyrotoxicosis even in patients with severe accompanying diseases .