Gadolinium as an Alternative Contrast Agent During Cardiac Catheterization in Patient with Iodine-induced Hyperthyroidism

Abstract

We report the first case of a male patient with iodine-induced hyperthyroidism and unstable angina pectoris in whom a diagnostic cardiac catheterization with gadolinium as contrast agent was chosen. The patient was hospitalized with an iodine-induced hyperthyroidism after angioplasty using an iodinated contrast agent. He presented with a continuous arrhythmia and unstable angina pectoris. A repeated cardiac catheterization using iodinated contrast agent was contraindicated. This case report shows that gadolinium is a useful alternative contrast agent for cardiac intervention in patients with iodine-induced hyperthyroidism.

Iodine-induced hyperthyroidism - gadolinium - cardiac catheterization

References

• 3 Bokhari S W, Wen Y H, Winters R J. Gadolinium-based percutaneous coronary intervention in a patient with renal insufficiency.  Catheter Cardiovasc Interv. 2003;  58(3) 358-361
• 4 Erly W K, Zaetta J, Borders G T, Ozgur H, Gabaeff D R, Carmody R F, Seeger J. Gadopentetate dimeglumine as a contrast agent in common carotid arteriography.  Am J Neuroradiol. 2000;  21 964-967
• 5 Hammer F D, Goffette P P, Malaise J, Mathurin P. Gadolinium dimeglumine: An alternative contrast agent for digital subtraction angiography.  Eur Radiol. 1999;  9 128-136
• 6 Joffe P, Thomsen H S, Meusel M. Pharmacokinetics of gadodiamide injection in patients with severe renal insufficiency and patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis.  Acad Radiol. 1998;  5 491-502
• 7 Parle J V, Maisonneuve P, Sheppard M C, Boyle P, Franklyn J A. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study.  Lancet. 2001;  358(9285) 861-865
• 8 Ose K, Doue T, Zen K, Hadase M, Sawada T, Azuma A, Matsubara H. “Gadolinium” as an alternative to iodinated contrast media for X‐ray angiography in patients with severe allergy.  Circ J. 2005;  69(4) 507-509
• 9 Prince M R, Arnoldus C, Frazoll J K. Nephrotoxicity of high dose gadolinium compared with iodinated contrast material.  J Magn Reson Imaging. 1996;  6 162-166
• 10 Sarkis A, Badaoui G, Slaba S, Moussalli A, Jebara V A. Gadolinium-based coronarography in a patient with renal failure: first clinical report.  Catheter Cardiovasc Interv. 2001;  54 68-69
• 11 Spinosa D J, Angle J F, Hagspiel K D, Schenk W GIII, Matsumoto A H. CO2 and gadopentetate dimeglumine as alternative contrast agent for malfunctioning dialysis grafts and fistulas.  Kidney Int. 1998;  54 945-950
• 14 Völzke H, Lüdemann J, Robinson D M, Spieker K W, Schwahn C, Kramer A, John U, Meng W. The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area.  Thyroid. 2003;  13(8) 803-810