Abstract
Unexpectedly, the administration of only 1 ml radiopaque dye and a single skin disinfection with PVP-iodine (PVP-I) induced clinical hypothyroidism in a premature newborn. Therefore, we studied the impact of two different, non-ionic, iodine containing contrast agents (administered for diagnostic reasons), Amipaque 01) and Omnipaque (2), and of PVP-I alone (3) on the immature thyroid gland by measuring TSH, T4, T3 and I excretion before, 5 and 14 days (TSH 0, 5, 14, resp.) after I-exposure. Rarely infants of group 1 and 2 received single doses of PVP-I. The content of free iodide is higher in the solubilized contrast agent (Omni-paque). TSH values(μU/ml) are shown below (medians):
Total iodine excretion was excessively increased in all groups. In group 1, T4 and T3 levels were in the lower normal range and only 1 case of transient hyperthyrotropinemia was observed. In groups 2 and 3 T4 and T3 values were very low; we diagnosed hypothyroidism in 90 % of preterm and in 30 % of term infants and treated 8 in whom hypothyroidism persisted for > 14 days.
Conclusion: Prematurity and iodide content are responsible for the occurrence of transient hypothyroidism in infants in intensive care.
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l'Allemand, D., Grueters, A., Beyer, P. et al. IODINE IN CONTRAST AGENTS AND SKIN DISINFECTANTS IS THE MAJOR CAUSE OF HYPOTHYROIDISM IN PREMATURE INFANTS DURING INTENSIVE CARE. Pediatr Res 20, 1194 (1986). https://doi.org/10.1203/00006450-198611000-00121
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DOI: https://doi.org/10.1203/00006450-198611000-00121