1.
Induction of thyroid neoplasm following plant medicine marine algae (sargassum): a rare case and review of the literature.
Zhu, G, Musumeci, F, Byrne, P
Current pharmaceutical biotechnology. 2013;(9):859-63
Abstract
In this study induction of neoplasm in thyroid gland of one postoperative patient with breast cancer was conducted by marine algae (also seaweed, sargassum), which is presented here. A 41-year-old women was diagnosed as her right breast cancer complicated with lymph node metastasis in her right axilla on February, 1999. In June 19, 1999 she was given the combination chemotherapy of vincristine, cyclophosphamide, 5-Fluorouracil and cinobufacini drugs due to two lymph nodes on her right superclavicular following radical mastectomy. During chemotherapy she was also taken the adjuvant treatment of traditional medicine. Traditional medicine consisted of seaweed plant drugs (containing iodine 362,400 ug/kg). As to intermittent maintance treatment the total dosage of seaweed herb was at least exceeded 500 gram. Induction of thyroid tumor (thumb size) was found in June, 2001. A thyroidectomy due to thyroma was successfully performed. Histologically there revealed thyroid tissue without the evidence of metastasis of breast cancer. She had a 5-year survivor. The data indicated oncogenic function of some traditional herbs, and further experience of traditional medicine in treating thyroid disease especially in thyroid cancer.
2.
[Kidney and iodinated and gadolinium-based contrast agents].
Clément, O, Faye, N, Fournier, L, Siauve, N, Frija, G
Journal de radiologie. 2011;(4):291-8
Abstract
UNLABELLED In patients with renal failure, iodinated contrast agents may cause acute deterioration of the renal function and gadolinium-based contrast agents (GBCAs) may cause nephrogenic systemic fibrosis (NSF). The administration of a contrast agent must thus be reviewed for each patient and evaluation of renal function is paramount even though its estimation using formulas derived from the creatinine level may fluctuate. For iodinated contrast agents, contrast induced nephropathy is reduced by hydratation, preferably intravenous, when the GFR is less than 60 ml/min. The risk for intravenous injections is less than the risk for arterial injections, and the GFR threshold may be reduced to 45 ml/min. For gadolinium-based contrast agents, patients at risk for NSF are those with end-stage renal disease and patients undergoing dialysis. In such cases, the injection of a gadolinium-based contrast agent is only considered after a risk-benefit analysis has been completed, an alternate linear or macrocyclic agent issued and the dose limited to 0,1 mmol Gd/kg. Recently, recommendations from US and European agencies have converged. LEARNING OBJECTIVES to be familiar with the risk factors of CIN with iodinated contrast agents; to be familiar with hydration procedures for patients at risk of CIN; to be familiar with the diagnostic criteria of NSF; to be familiar with the classification of GBCA with regards to the risk of NSF; to be familiar with the contraindications of the different groups of GBCA.
3.
Life-threatening hyponatremia following a low-iodine diet: a case report and review of all reported cases.
Al Nozha, OM, Vautour, L, How, J
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2011;(5):e113-7
Abstract
OBJECTIVE To report a case of life-threatening hyponatremia as a complication of a 4-week long low-iodine diet and highlight the risk factors for this complication by reviewing all previously reported cases. METHODS The clinical and biochemical data from the study patient are presented and the pertinent literature is reviewed. A risk analysis for this complication is highlighted. RESULTS A 66-year-old Vietnamese woman had a total thyroidectomy and bilateral neck lymph node dissection for papillary thyroid carcinoma. A whole body radioiodine scan demonstrated 2 foci of activity in the anterior neck. The patient received recombinant human thyrotropin (rhTSH) and was admitted for radioiodine therapy. She had strictly adhered to a low-iodine diet for 4 weeks in preparation for ablation. The patient was on a thiazide diuretic for her hypertension, which was discontinued on admission. On admission, the patient started feeling light-headed, dizzy, and nauseated. Blood tests revealed a critical serum sodium concentration of 107 mEq/L. Further investigations confirmed hypotonic hyponatremia, which had developed despite being euthyroid after receiving rhTSH. The patient was managed accordingly and made a full recovery. CONCLUSIONS This case, in addition to the reviewed cases, emphasizes the importance of preventing and managing this rare but relatively dangerous complication. Based on an analysis of the reviewed cases, the risk factors for developing this complication are a prolonged low-iodine diet, the elimination of salt from the diet, and the use of thiazide diuretics. All patients in the reported cases were older than 65 years of age.