Iopanoic acid in the management of neonatal Graves' disease.
OBJECTIVE
Traditionally, neonatal thyrotoxicosis has been managed with antithyroid drugs and/or iodine as well as sedatives, propranol and digitalis when necessary. The purpose of this study was to evaluate the management of neonatal thyrotoxicosis using the radio-contrast agent iopanoic acid.


METHODS
We managed five cases of neonatal thyrotoxicosis. All infants were treated initially with propranolol (1.7 mg/kg/day) and iopanoic acid 250 to 500 mg every third or fourth day.


RESULTS
In all cases, clinical signs improved and T(3) and T(4) levels decreased dramatically within 24 to 72 hours. No toxic side effects were noted.


CONCLUSIONS
Neonatal thyrotoxicosis can be managed successfully using iopanoic acid. Iopanoic acid is essentially free of side effects and need only be administered every 3 to 4 days. When administered until (transplacental) maternal TSI has been metabolized by the neonate, iopanoic acid maintains euthyroid status with no risk of hypothyroidism. With conventional therapy, propylthiouracil (PTU) must be administered three times a day. PTU also carries a significant risk of toxic side effects and a week or more of therapy is required to correct the hyperthyroid state and may induce hypothyroidism.
Earles
Sonja M
SM
Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Gerrits
Peter M
PM
Transue
David J
DJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D003287:Contrast Media / Q000008:administration & dosage / Q000627:therapeutic use*; D006111:Graves Disease / Q000188:drug therapy*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D007231:Infant, Newborn; D007480:Iopanoic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D003287:Contrast Media; D018828:Immunoglobulins, Thyroid-Stimulating; D011433:Propranolol; D007480:Iopanoic Acid