Iodine-containing ointment-induced hypothyroidism in a patient with anorexia nervosa and sacral decubitus ulcer: a case report with literature review

Endocr J. 2022 Dec 28;69(12):1423-1429. doi: 10.1507/endocrj.EJ22-0248. Epub 2022 Sep 3.

Abstract

We present a case of a 58-year-old woman with anorexia nervosa and a sacral decubitus ulcer who developed hypothyroidism because of an iodine-containing ointment. Considering the absence of autoimmune thyroid diseases, the development of hypothyroidism after the use of an iodine-containing ointment, and the recovery of thyroid function after the discontinuation of the ointment, we presumed that her hypothyroidism was induced by the iodine-containing ointment. Although the hypothyroidism improved after discontinuing the iodine-containing ointment, she developed aspiration pneumonia and required long-term hospitalization. Many patients with autoimmune thyroid diseases develop hypothyroidism after excessive iodine intake. However, anorexia nervosa may have exacerbated the iodine-induced hypothyroidism in our patient. To the best of our knowledge, no previous study has reported a case of hypothyroidism caused by iodine-containing ointment in a patient with anorexia nervosa. Hence, physicians must pay careful attention to a patient's background factors to ensure the early diagnosis of hypothyroidism due to iodine-containing ointments.

Keywords: Anorexia nervosa; Decubitus ulcer; Hypothyroidism; Iodine-containing ointment.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Anorexia Nervosa* / complications
  • Female
  • Hashimoto Disease* / complications
  • Humans
  • Hypothyroidism* / chemically induced
  • Hypothyroidism* / complications
  • Hypothyroidism* / diagnosis
  • Iodine* / adverse effects
  • Middle Aged
  • Ointments / adverse effects
  • Pressure Ulcer* / complications

Substances

  • Ointments
  • Iodine