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Angiology
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Acute Exacerbation of Masked Hyperthyroidism After Iodine Restriction Followed by Thyrotoxic Atrial Fibrillation and Cerebral Embolism

A Case Report

Takeo Kuroda

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Ken Okamura

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Kaori Sato

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Kaeko Inokuchi

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Tetsuya Mizokami

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Masatoshi Fujishima

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

The authors present a seventy-two-year-old woman complaining of diffuse and firm goiter. At the first visit, she looked almost euthyroid with regular pulse rate of 78 per minute. After iodine restriction, however, she became severely thyrotoxic and developed cerebral embolism associated with atrial fibrillation due to Graves' hyperthyroidism. In conclusion, sudden withdrawal of dietary iodine might lead to exacerbation of Graves' hyperthyroidism resulting in serious cardiovascular or cerebrovascular complications, especially in elderly patients.

Angiology, Vol. 47, No. 7, 709-712 (1996)
DOI: 10.1177/000331979604700712
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