Thyroid dysfunction in preterm neonates exposed to iodine

AbstractBackground:Infants <32 weeks’ gestation should not be exposed to topical iodine and its avoidance is recommended during pregnancy and breast feeding. Exposure to contrast media and topical iodine is frequently used in many preterm neonates.Aim:To determine whether thyrotropin levels in preterm infants are affected by exposure to intrapartum/neonatal topical iodine and/or the use of iodinated contrast media.Design:Infants <32 weeks’ gestation were recruited. Maternal and neonatal exposures to iodinated contrast media and topical iodine were recorded; levels of thyrotropin and thyroxine were measured from blood-spot cards on postnatal days 7, 14, 28 and the equivalent of 36 weeks’ gestation.Results:One hundred and twenty-five infants were exposed to topical iodine/contrast media and 48 infants were unexposed. No infants were treated for hypothyroidism; three infants (exposed group) had transient hyperthyrotropinaemia. Mean thyrotropin levels were significantly higher on postnatal days 7, 14 and 28 in infants exposed to topical iodine prior to caesarean section compared to unexposed infants, a relationship which persisted after adjustment.Conclusions:In the context of this study, neonatal thyroid dysfunction was seen following exposure to iodine via caesarean section but not via exposure to contrast media.

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Thyroid Dysfunction in Children Exposed to Iodinated Contrast Media

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2016-1330 ◽

2016 ◽

Vol 101 (6) ◽

pp. 2366-2370 ◽

Cited By ~ 23

Author(s):

Meaghan L. Barr ◽

Harvey K. Chiu ◽

Ning Li ◽

Michael W. Yeh ◽

Connie M. Rhee ◽

...

Keyword(s):

Contrast Media ◽

Thyroid Dysfunction ◽

Iodinated Contrast Media ◽

Iodinated Contrast

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Iodinated Contrast Media–Induced Thyroid Dysfunction in Euthyroid Nodular Goiter Patients

Thyroid ◽

10.1089/thy.2016.0051 ◽

2016 ◽

Vol 26 (8) ◽

pp. 1030-1038 ◽

Cited By ~ 7

Author(s):

Edy Kornelius ◽

Jeng-Yuan Chiou ◽

Yi-Sun Yang ◽

Shih-Chang Lo ◽

Chiung-Huei Peng ◽

...

Keyword(s):

Contrast Media ◽

Thyroid Dysfunction ◽

Nodular Goiter ◽

Iodinated Contrast Media ◽

Iodinated Contrast

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Iodinated contrast media-induced hyperthyroidism

Journal of Medical Science ◽

10.20883/medical.e439 ◽

2020 ◽

Vol 89 (2) ◽

pp. e439

Author(s):

Katarzyna Pelewicz ◽

Piotr Miśkiewicz

Keyword(s):

Contrast Media ◽

Interventional Procedures ◽

Thyroid Dysfunction ◽

Iodine Intake ◽

Prophylactic Therapy ◽

Iodinated Contrast Media ◽

Thyroid Status ◽

Contrast Administration ◽

Iodinated Contrast ◽

Clinically Significant

Currently, iodinated contrast media (ICM) is widely used in radiology, therefore numerous patients are exposed to contrast administration during diagnostic and interventional procedures. ICM contains an amount of iodine well above the recommended dietary allowance, which can lead to thyroid dysfunction. Indeed, individuals that are highly susceptible to increased iodine intake are often patients with pre-existing thyroid disease. ICM-induced hyperthyroidism (IIH) is usually transient, however, it may present as clinically significant thyrotoxicosis. Although IIH has been investigated in multiple studies, there is still a lack of consensus regarding prophylactic therapy of IIH and no specific guidelines. This review aimed to summarise previous literature concerning the influence of ICM exposure on thyroid status and prophylactic therapy of IIH.

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Effect of iodinated contrast media on thyroid: a brief review

Journal of Health Sciences ◽

10.17532/jhsci.2016.278 ◽

2016 ◽

Vol 6 (1) ◽

pp. 12-15

Author(s):

Şerife Mehlika Kuşkonmaz ◽

Sema Yıldız

Keyword(s):

Computed Tomography ◽

Contrast Media ◽

Contrast Agents ◽

Clinical Evaluation ◽

Thyroid Disease ◽

Thyroid Dysfunction ◽

Iodinated Contrast Media ◽

Iodinated Contrast ◽

Excess Iodide ◽

Iodinated Contrast Agents

In parallel to the increased use of computed tomography, iodinated contrast agents are increasingly becoming a source of excess iodide. Iodinated contrast agents may induce thyroid dysfunction in exposed patients, especially in the presence of an underlying thyroid disease. Thus, an ordinary dose of the contrast used for the imaging, can induce hyper or hypothyroidism in a patient with subtle thyroid disease. This review will briefly discuss the physiology of iodine and the clinical evaluation of iodine induced thyroid dysfunction.

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Iodinated contrast media: thyroid dysfunction in infants

Reactions Weekly ◽

10.1007/s40278-015-10964-6 ◽

2015 ◽

Vol 1579 (1) ◽

pp. 3-3

Keyword(s):

Contrast Media ◽

Thyroid Dysfunction ◽

Iodinated Contrast Media ◽

Iodinated Contrast

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Iodine contrast prior to or during pregnancy and neonatal thyroid function: a systematic review

Acta Endocrinologica ◽

10.1530/eje-20-0627 ◽

2021 ◽

Vol 184 (1) ◽

pp. 189-198 ◽

Cited By ~ 1

Author(s):

Nienke van Welie ◽

Maite Portela ◽

Kim Dreyer ◽

Linda J Schoonmade ◽

Madelon van Wely ◽

...

Keyword(s):

Systematic Review ◽

Contrast Media ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Meta Analysis ◽

Cochrane Library ◽

Iodinated Contrast Media ◽

Iodinated Contrast ◽

Increased Risk ◽

Neonatal Thyroid Function

Objective Thyroid dysfunction is a known side effect of iodinated contrast media. There is some evidence to suggest that iodinated contrast media administered to pregnant women may cause thyroid dysfunction not only in themselves but also in their offspring. Here, we systematically evaluated literature on the use of iodinated contrast media prior to or during pregnancy on the offspring’s thyroid function. Design Systematic review of published literature. Materials and methods Relevant studies were identified by PubMed, EMBASE and The Cochrane Library up to June 5, 2020. All study designs, reporting on the foetal or neonatal thyroid function after exposure to iodinated contrast media prior to or during pregnancy, were included. We undertook random effects meta-analysis and pooled the estimates as proportions with 95% CIs. Results We identified 402 articles, of which 26 were included. Six studies reported (n = 369) on exposure to iodinated contrast media prior to pregnancy by hysterosalpingography and 20 studies (n = 670) on exposure to these media during pregnancy by amniofetography, urography or CT. There was low to high risk of bias. The proportion of (transient) neonatal thyroid dysfunction was 0.0% (95% CI: 0.0–2.9% based on 3 studies) for hysterosalpingography, 2.25% (95% CI: 0.03–6.55% based on 2 studies) for amniofetography and 0.0% (95% CI: 0.0–0.02% based on 5 studies) for CT. There was a tendency towards an increased risk of thyroid dysfunction with higher amounts of contrast used. Conclusions Exposure to iodinated contrast media prior to or during pregnancy may increase the risk of thyroid dysfunction in offspring. We recommend keeping the amount of contrast used as low as possible.

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