Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website https://www.jofem.org

Case Report

Volume 10, Number 3-4, August 2020, pages 101-105


A Case Report of Water Intoxication During Radioactive Iodine Treatment: Why Physicians Should Communicate Clearly With Patients

Figures

Figure 1.
Figure 1. The 74 MBq scan with I-131 showing two foci of uptake in the neck, consistent with remnant thyroid tissue (indicated by arrow).
Figure 2.
Figure 2. SPECT/CT reconstructed images of the neck and thorax (following 74 MBq of I-131) showing uptake of tracer in the thyroid bed, right side more than the left side (indicated by arrow). SPECT/CT: single photon emission tomography/computed tomography.
Figure 3.
Figure 3. CT scan of the brain showing the small focus of calcification in the left occipital lobe of the brain (indicated by arrow). CT: computed tomography.

Table

Table 1. Blood Results at the Various Points in Time
 
ParameterBaselineFirst onset of symptomsIn ICUPrior to discharge from ICUReference range
Liver function tests and blood gases were within normal reference ranges and not indicated here. ICU: intensive care unit; eGFR: estimated glomerular filtration rate; MDRD: Modification of Diet in Renal Disease; TSH: thyroid stimulating hormone.
Na+148 mmol/L112 mmol/L113 mmol/L131 mmol/L136 - 145 mmol/L
K+4.3 mmol/L4.2 mmol/L3.9 mmol/L4.6 mmol/L3.5 - 5.1 mmol/L
Urea3.2 mmol/L1.3 mmol/L--2.1 - 7.1 mmol/L
Creatinine55 µmol/L53 µmol/L--49 - 90 µmol/L
eGFR (MDRD formula)> 60 mL/min/1.73 m2> 60 mL/min/1.73 m2--
Corrected Ca2+-2.01 mmol/L1.50 mmol/L1.89 mmol/L2.15 - 2.50 mmol/L
Red blood cells-10.1 mmol/L--3.93 - 5.40 × 109/L
White blood cells-13.14 × 109/L--3.90 - 12.60 × 109/L
Hemoglobin-10.6 g/dL--11.6 - 16.4 g/dL
C-reactive protein-< 10 mg/L--< 10 mg/L
free T45.3 pmol/L1.1 pmol/L--12.0 - 22.0 pmol/L
TSH66.53 mIU/L---0.27 - 4.20 mIU/L
Urine osmolality--86 mmol/kg-50 - 1,200 mmol/kg
Blood osmolality--252 mmol/kg-275 - 295 mmol/kg
Bicarbonate--15 mmol/L16 mmol/L23 - 29 mmol/L
Cl---81 mmol/L97 mmol/L98 - 107 mmol/L