Requesting iodine supplementation in children on parenteral nutrition.
OBJECTIVE
Iodine supplementation of parenterally fed infants recommended by ESPGHAN is 1 microg/kg/day. To assess nutritional and thyroid status of children on parenteral nutrition (PN) through urinary iodine concentration (UIC).


METHODS
Children (1-17 yrs), undergoing PN and receiving an iodine supply of 1 microg/kg/day, were enrolled from 2000 to 2007.


RESULTS
We observed 15 children (10 males, mean age 76.53+/-60.4 months) on PN from 14 to 84 weeks (mean 38.5+/-21.4). Ten were on TPN and five on PPN; nine had short bowel syndrome (SBS) and six had other intestinal diseases requiring PN. Iodine supply in TPN ranged between 1 and 1.6 microg/kg/day (mean 1.1+/-0.3 microg/kg/day), while in PPN it ranged from 2.3 to 2.8 microg/kg/day (mean 2.6+/-0.7 microg/kg/day). We found an inverse correlation between duration of PN in months and UIC (P=0.05). Four weeks after PN onset, UIC<100 microg/L was found in all SBS patients and 3/6 non-SBS patients (P<0.05). After 12 weeks, 8/15 (53%) patients had UIC<50 microg/L, but thyroxine, TSH and thyroid volume remained unchanged.


CONCLUSIONS
A PN iodine supply of 1 microg/kg/day may be suboptimal. Higher supplies should be evaluated in controlled trials.
Cicalese
M P
MP
Department of Paediatrics, University of Naples Federico II, Via Pansini 5, Naples, Italy. mariapia.cicalese@tiscali.it
Bruzzese
E
E
Guarino
A
A
Spagnuolo
M I
MI
D000293:Adolescent; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000503:physiopathology / Q000628:therapy; D007455:Iodine / Q000008:administration & dosage* / Q000172:deficiency / Q000652:urine*; D008297:Male; D009751:Nutritional Requirements; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011446:Prospective Studies; D012778:Short Bowel Syndrome / Q000503:physiopathology / Q000628:therapy; D013961:Thyroid Gland / Q000033:anatomy & histology / Q000502:physiology
D007455:Iodine