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Hypothyroidism caused by topical povidone-iodine in a newborn with omphalocele

B C Cosman1, J N Schullinger, J J Bell

  • 1Department of Surgery, Columbia University, New York, NY.

Journal of Pediatric Surgery
|April 1, 1988
PubMed

Insights

Topical povidone-iodine (PVPI) application in newborns can cause temporary hypothyroidism. This case highlights the importance of monitoring thyroid function in infants exposed to PVPI, especially those with omphaloceles.

Area of Science:

  • Neonatal endocrinology
  • Pediatric surgery
  • Dermatology

Background:

  • Povidone-iodine (PVPI) is a common antiseptic used in neonatal care.
  • Systemic absorption of iodine from PVPI can occur, particularly through compromised skin barriers.
  • Omphalocele presents a unique challenge due to the exposed abdominal contents and potential for increased PVPI absorption.

Observation:

  • A newborn with an omphalocele developed physiologic hypothyroidism.
  • The hypothyroidism was directly linked to the repeated topical application of povidone-iodine (PVPI) for wound care.
  • Thyroid hormone levels normalized after discontinuation of PVPI exposure.

Findings:

  • Physiologic hypothyroidism in neonates can be iatrogenically induced by topical povidone-iodine (PVPI).
  • The degree of systemic absorption and subsequent thyroid dysfunction is influenced by the extent of skin exposure and application frequency.
  • Neonates with omphaloceles are at increased risk due to the large surface area of exposed tissue.

Implications:

  • Clinical vigilance is crucial for identifying thyroid dysfunction in neonates treated with topical PVPI.
  • Alternative antiseptics or judicious PVPI use may be warranted in neonates with omphaloceles.
  • This case underscores the need for standardized protocols regarding PVPI application in vulnerable neonatal populations.

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