title: Thyroid Dysfunction in Children Exposed to Iodinated Contrast Media.
abstract: Iodinated contrast media (ICM) is routinely used in imaging studies and contains several 100-fold the recommended daily allowance of iodine.
  
  
  
  To determine whether children exposed to ICM have a higher risk of iodine-induced thyroid dysfunction.
  
  
  
  This was a single-institution case-control study, examining patients with incident thyroid dysfunction aged less than 18 years from 2001 to 2015. Cases were matched 1:1 to euthyroid controls by age, sex, and race.
  
  
  
  This was a single-institution case-control study occurring at tertiary care center.
  
  
  
  Cases were defined as those with thyroid dysfunction (by International Classification of Diseases, Ninth Revision diagnosis codes and/or 2 consecutive abnormal serum TSH values <6 mo apart). We analyzed 870 cases matched to 870 controls (64% female, 51% White).
  
  
  
  Using conditional logistic regression, the association between ICM exposure and the primary outcome, thyroid dysfunction, occurring within 2 years of exposure was assessed.
  
  
  
  Sixty-nine patients received ICM, including 53 (6%) among cases and 16 (2%) among controls. The risk of incident hypothyroidism was significantly higher after ICM exposure (odds ratio 2.60; 95% confidence interval, 1.43-4.72; P < .01). The median interval between exposure and onset of hypothyroidism was 10.8 months (interquartile range, 6.6-17.9). In hypothyroid cases, the median serum TSH concentration was 6.5 mIU/L (interquartile range, 5.8-9.6).
  
  
  
  ICM exposure increases the risk of incident hypothyroidism in pediatric patients. Children receiving ICM should be monitored for iodine-induced thyroid dysfunction, particularly during the first year after exposure.
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Meaghan L
authors.initials: ML
authors.lastname: Barr
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Harvey K
authors.initials: HK
authors.lastname: Chiu
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Yeh
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Connie M
authors.initials: CM
authors.lastname: Rhee
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Casillas
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Iskander
authors.affiliation: University of California Los Angeles (UCLA) David Geffen School of Medicine (M.L.B.), Los Angeles 90073, California; Division of Pediatric Endocrinology (H.K.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Biomathematics (N.L.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Section of Endocrine Surgery (M.W.Y.), Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Nephrology and Hypertension (C.M.R.), University of California Irvine School of Medicine, Irvine, California 92697; Division of Pediatric Hematology and Oncology (J.C.), Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California 90073; Department of Radiology (P.J.I.), UCLA David Geffen School of Medicine, Los Angeles, California 90073; Division of Endocrinology (A.M.L.), Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California 90073; and Division of Endocrinology (A.M.L.), Veterans' Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Leung
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D013959:Thyroid Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D013961:Thyroid Gland
chemical_list: D003287:Contrast Media