Endocrine Abstracts

Introduction: Hysterosalphingography (HSG) is the radiographic examination of uterine cavity and fallopian tubes. It is generally used during evaluation of infertility and radioopaque contrast is injected through cervical duct during the procedure. Lipiodol which is the most commonly used contrast media in HSG is a fatsoluble iodinated contrast media. This iodine is progressively cleared from the body in a period ranging from a few weeks to a few months. Here, we present a 6 week pregnant woman who underwent HSG 9 months ago and has very high urinary iodine excretion.

Case: A 31 years old woman at the 6th week of pregnancy was consultated for high blood glucose. She was evaluated for infertility for 2 years, and HSG was performed 9 months before conception. There was no history of drug or nutritional supplement use that has high iodine content and that might affect iodine status. Iodine excretion was 10087 mcg/L (100–700 mcg/L) in random urine sample and >450 ug/L in 24 hour urine. Her serum TSH was 2.19 uIU/ml, fT4 was 1.32 ng/dl and fT3 was 1.32 pg/ml. Thyroid autoantibodies were negative and thyroid ultrasonography was normal.

Conclusion: The optimal time for normalization of body iodine stores after exposure of iodinated contrast media is not known exactly. Thyroid dysfunctions in the form of both hypothyroidism or thyrotoxicosis can develop in euthyroid subjects after use of iodinated contrast media during HSG. In our case, thyroid functions were normal but urinary iodine was very high even several months after HSG. This suggests that females at reproductive age who underwent HSG might have excess iodine concentration for a prolonged time and should be carefully evaluated for development of thyroid dysfunctions.