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

• Published in: Endocrine Journal p. EJ22-0248
• Main Authors: Fujita, Naoya, Ono, Yosuke, Kobayashi, Takahiro, Kozono, Sawako, Horiuchi, Yugo, Sano, Azusa, Kawamura, Yusuke, Miyoshi, Yuka, Kimata, Motohiro, Sekizawa, Akinori, Hashimoto, Kenichi, Obuchi, Yasuhiro, Tanaka, Yuji
• Format: Journal Article
• Language: English
• Published: The Japan Endocrine Society 2022
• Subjects: Anorexia nervosa; Decubitus ulcer; Hypothyroidism; Iodine-containing ointment
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ22-0248

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.