Right time to detect urine iodine during papillary thyroid carcinoma diagnosis and treatment: A case report |
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Authors: | Shi-Chang Zhang Cheng-Jing Yan Yun-Fei Li Ting Cui Mei-Ping Shen Jie-Xin Zhang |
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Affiliation: | Shi-Chang Zhang, Cheng-Jing Yan, Yun-Fei Li, Ting Cui, Jie-Xin Zhang, Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, ChinaMei-Ping Shen, Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China |
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Abstract: | BACKGROUNDThis is the first documentation of a spontaneous and nonspecific chemical reaction of an iodinated contrast media with ammonium persulfate used in As3+-Ce4+ catalytic spectrophotometry for urine iodine concentration (UIC) detection.CASE SUMMARYWe herein report an incidental case who had a dual source computed tomography examination for papillary thyroid carcinoma diagnosis. Serial spot urine specimens were collected during her hospitalization and were measured by As3+-Ce4+ catalytic spectrophotometry on a Beckman Coulter AU5800. The reacted solutions were “brownish”, and the results showed extremely high iodine concentrations despite serial dilutions. The patient claimed no dietary habit of iodized salt or iodine-containing medical history, which strongly pointed to iodinated contrast media (ICM) via intravenous injection. Even with 0.01% ICM, its interruption is still profound on the desired urine iodine reaction with ammonium persulfate, leading to inaccurate UIC and possibly inappropriate treatment.CONCLUSIONThe following laboratory suggestions should be considered: (1) As3+-Ce4+ catalytic spectrophotometry is only suitable for UIC measurement after confirmed ICM renal clearance; (2) A mass spectrometry-based method can be applied as an alternative during the ICM clearance period; and (3) The UIC baseline can be confirmed after ICM injection by consecutive detection for at least 2 mo. |
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Keywords: | Papillary thyroid carcinoma Urine iodine concentration Iodinated contrast media As3+-Ce4+ catalytic spectrophotometry |
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