# Jod-Basedow Phenomenon Precipitating Diabetic Ketoacidosis: A Case Report

## TL;DR

A 50-year-old woman with diabetes developed diabetic ketoacidosis after exposure to iodine from a medical procedure, highlighting a rare but serious thyroid-related complication.

## Contribution

This case report highlights the underdiagnosed risk of iodine-induced thyroid dysfunction precipitating acute diabetes complications.

## Key findings

- Exposure to iodinated contrast medium triggered thyrotoxicosis in a patient with silent thyroid disease.
- Thyrotoxicosis led to diabetic ketoacidosis in a patient with type 2 diabetes.
- The case underscores the importance of recognizing Jod-Basedow phenomenon in at-risk patients.

## Abstract

Jod-Basedow phenomenon (JBP) is an alternative term for iodine-induced thyrotoxicosis, which is a rare hyperthyroid illness that is brought on by excessive iodine exposure. Patients with underlying thyroid conditions, autoimmune diseases, or chronic renal disease are populations frequently affected by the JBP. The potential for this disorder to circumvent normal thyroid autoregulation and result in potentially fatal consequences makes it especially worrying.

Here, we describe the case of a 50-year-old woman who had a known case of dyslipidemia, cardiomyopathy, and type 2 diabetes and presented to the emergency department with complaints of nausea and stomach pain. Diabetic ketoacidosis (DKA) was suspected based on venous blood gas reports that showed significant anion gap metabolic acidosis. Imaging revealed characteristics indicative of thyroiditis, and additional testing verified hyperthyroidism. Interestingly, the patient had only had iodinated contrast medium coronary angiography one day before presentation to the emergency department. This case highlights the underdiagnosed yet severe risk of iodine-induced thyroid dysfunction, particularly in patients with silent thyroid disease, which can precipitate acute conditions such as DKA.