Thyroid disease following the administration of thorotrast

SHORT-TERM EFFECTS OF CORONARY ANGIOGRAPHIC CONTRAST AGENTS ON THYROID FUNCTION

OBJECTIVE

To determine the effect of two iodine-containing contrast agents used for coronary angiography on subsequent thyroid hormone concentrations.

METHODS

We prospectively studied thyroid function in 56 patients, with no previous history of thyroid disease and normal findings on thyroid examinations, who underwent nonemergent cardiac catheterization. Thyroid hormone concentrations were assessed at baseline and at day 1 and day 7 after administration of a radiographic iodinated contrast agent (Renografin or Omnipaque).

RESULTS

Use of Omnipaque and Renografin was not associated with significant changes in thyroid-stimulating hormone, total thyroxine, triiodothyronine resin uptake, free thyroxine index, or total triiodothyronine. Three patients had slightly increased thyroid-stimulating hormone concentrations at 7 days after angiography.

CONCLUSION

Administration of iodinated contrast agents for cardiac catheterization does not result in hyperthyroidism in patients with previously normal findings on thyroid examination.

Thorotrast granuloma of the neck with local complications

A case of cervical granuloma with involvement of the right vocal cord is reported. The cause of the granuloma was traced to thorium dioxide contrast medium which had escaped into the surrounding tissues during arteriography performed 40 years before. The long-term toxic effects of thorium-232 irradiation and the local complications which may follow an injection of this medium are discussed.

Angiosarcoma of the liver: a marker tumour for the late effects of Thorotrast in Great Britain

Monitoring the incidence of angiosarcoma of the liver (ASL) between 1974 and 1977 has led to the confirmation by a panel of pathologists of 7 new cases of ASL in patients who had received intra-arterial Thorotrast for radiological investigations. A cluster of cases has appeared in and around Edinburgh where the use of Thorotrast was pioneered in Britain in 1933-48, and a mortality study of 113 Edinburgg patients has confirmed a significant excess of liver-tumour deaths in recent years. Deaths from cancers of the lung and breast, and from hepatic cirrhosis, were also in excess, but the limitations of the death-certificate data are described in relation to the clinical and pathological findings. Thorotrast was also used in other centres, and an increased incidence in Britain of liver tumours attributable to this agent is indicated.

Haemangioendothelioma (Kupffer cell angiosarcoma), myelofibrosis, splenic atrophy, and myeloma paraproteinaemia after parenteral thorotrast administration

A case of thorotrastosis occurred 25 years after thorotrast angiography, with the previously unrecorded association of myeloma type paraproteinaemia. The relationship between haemangioendothelioma due to thorotrast and other vascular sarcomas of the liver is briefly reviewed.

Long-term hazards of Thorotrast

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