Zhang SC, Yan CJ, Li YF, Cui T, Shen MP, Zhang JX. Right time to detect urine iodine during papillary thyroid carcinoma diagnosis and treatment: A case report. World J Clin Cases 2022; 10(30): 11010-11015 [PMID: 36338210 DOI: 10.12998/wjcc.v10.i30.11010]
Corresponding Author of This Article
Jie-Xin Zhang, MD, PhD, Associate Professor, Senior Researcher, Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. jiexinzhang@njmu.edu.cn
Research Domain of This Article
Biochemistry & Molecular Biology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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, China
Mei-Ping Shen, Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Yan CJ and Li YF participated in data collection; Cui T and Shen MP gave expertise advice; Zhang SC and Zhang JX conceived and coordinated the study; all authors participated in manuscript writing.
Supported bythe “The Six Top Talent Project” of Jiangsu Province, No. WSW-004; the Key Laboratory for Laboratory Medicine of Jiangsu Province of China, No. ZDXKB2016005.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie-Xin Zhang, MD, PhD, Associate Professor, Senior Researcher, Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. jiexinzhang@njmu.edu.cn
Received: February 11, 2022 Peer-review started: February 11, 2022 First decision: June 16, 2022 Revised: July 7, 2022 Accepted: September 19, 2022 Article in press: September 19, 2022 Published online: October 26, 2022 Processing time: 252 Days and 1.8 Hours
Abstract
BACKGROUND
This 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 SUMMARY
We 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.
CONCLUSION
The 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.
Core Tip: There has been no report on the nonspecific chemical reaction of an iodinated contrast media with ammonium persulfate used in As3+-Ce4+ catalytic spectrophotometry thus far. We herein report a typical case, which might contribute to improving our understanding of the biochemistry mechanism as well as interpretation of the results of UIC detection during papillary thyroid carcinoma (PTC) diagnosis and treatment. This report also serves as a reminder to establish an individual flowchart to evaluate prognosis during PTC follow-up.
