title: Transient hypothyroidism in premature infants after short-term topical iodine exposure: an avoidable risk?
abstract: Studies in preterm infants have shown that prolonged treatment with topical iodine (multiple doses, often over multiple days) can transiently suppress thyroid function. However, it is uncertain if topical iodine exposure for very short periods of time can cause significant changes in thyroid function. We report two cases of transient hypothyroidism in preterm infants after short-term exposure to topical iodine during surgical preparation, and review their clinical and laboratory findings before and after iodine exposure. We conclude that premature infants are at risk of developing transient hypothyroidism in response to a single, short-term exposure to topical iodine, even in iodine-sufficient geographical areas. We advise monitoring of thyroid function in these infants after iodine exposure, as treatment with levothyroxine may be needed for a limited duration to prevent the sequelae of untreated hypothyroidism. Consideration of using alternative cleansing agents is also advised.
authors.affiliation: Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA. jordan.pinsker@us.army.mil
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Pinsker
authors.forename: Krista
authors.initials: K
authors.lastname: McBayne
authors.forename: Mary
authors.initials: M
authors.lastname: Edwards
authors.forename: Kirk
authors.initials: K
authors.lastname: Jensen
authors.forename: David F
authors.initials: DF
authors.lastname: Crudo
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bauer
mesh_terms: D000287:Administration, Topical; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced*; D007231:Infant, Newborn; D007234:Infant, Premature; D007455:Iodine / Q000008:administration & dosage / Q000009:adverse effects*; D012306:Risk
chemical_list: D007455:Iodine