Iodine overload and severe hypothyroidism in two neonates

Area of Science:

• Neonatal endocrinology
• Pediatric toxicology

Background:

• Iodine overload is a known cause of neonatal thyroid dysfunction, including transient hyperthyrotropinemia, hypothyroidism, and rarely hyperthyroidism.
• Iodine exposure in neonates can occur prenatally, perinatally, or postnatally.

Observation:

• Two cases of severe neonatal hypothyroidism resulting from iodine overload are presented.
• Case 1 involved excessive use of an iodinated antiseptic for umbilical cord care.
• Case 2 involved maternal iodine exposure and high iodine levels in breast milk.

Findings:

• Iodine overload can lead to severe, rather than transient, hypothyroidism in neonates.
• Specific sources of iodine overload, such as topical antiseptics and maternal transfer, were identified.

Implications:

• Highlights preventable causes of neonatal hypothyroidism.
• Emphasizes the importance of monitoring iodine exposure in newborns and breastfeeding mothers.
• Suggests a need for revised guidelines on the use of iodinated antiseptics in neonatal care.