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How dangerous is the iodide load/exposure from say a CT chest w/ IV contrast in these patients who have not yet had pre-treatment (i.e. propranolol ptu etc)? Anecdotally, I've had two cases (thyrotoxicosis) where before the diagnosis was made the patient received IV contrast. The patients did not seem to have any adverse reaction but would be interested in hearing the group's thoughts as I would image a sizable portion of these patients get contrast exposure before a diagnosis is made.
I had this same thought while listening. It may be the cost of doing business where rapid CT is indicated based on presentation, but otherwise it seems prudent to wait for labs to order the scan in patients where thyroid disease is higher on your differential.
What you do matters.