Beneficial Effects of Lithium and Radioiodine Therapy in the Treatment of Hyperthyroidism

ABSTRACT

Intravenous contrast media used for coronary angiography are iodine-based and could induce thyroid gland dysfunction. We present the case of a 58-year-old woman with coronary artery disease who developed hyperthyroidism after percutaneus coronary intervention. Treatment with thiamazole induced agranulocytosis, complicated with severe tonsillitis. During recurrence of hyperthyroidism, after careful assessment of available methods of treatment, she was recommended to undergo radioiodine therapy (131I). The patient received lithium carbonate as pre-treatment. After 13 days of pre-treatment, patient received the therapeutic dose of 131I. Neither thyrotoxicosis progression nor acute coronary syndrome occurred. After 3 weeks, her thyroid hormones were found to be within normal ranges. Lithium therapy could be used as an effective treatment in patients who developed serious side-effects due to previous treatment with thionamides.