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Published on: February 16, 2016
Investigating thyroid dysfunction in pediatric patients following the administration of iodinated contrast media
William Wyatt Lindsey1, Alycia P Heiner2, Kristen E Barbieri2
1Department of Clinical Sciences, Alabama College of Osteopathic Medicine, Dothan, AL, USA.
Insights
Iodinated contrast media (ICM) exposure did not significantly impact thyroid function in young children undergoing cardiac catheterization. Routine thyroid screening after these procedures may not be necessary for this population.
Area of Science:
- Pediatric Cardiology
- Pediatric Endocrinology
- Radiology
Background:
- Iodinated contrast media (ICM) are frequently used in pediatric cardiac catheterization.
- Thyroid dysfunction is a potential concern following ICM exposure.
- Current guidelines recommend thyroid function testing after ICM exposure, but its utility in young children is debated.
Purpose of the Study:
- To determine the incidence and severity of thyroid dysfunction after ICM exposure in children under four years old.
- To assess adherence to FDA guidelines for post-procedure thyroid function testing.
- To evaluate the necessity of routine thyroid function tests in this pediatric cohort.
Main Methods:
- Retrospective chart review of 186 patients under four years old undergoing cardiac catheterization.
- Data collected included ICM exposure, age, sex, gestational age, ethnicity, and post-procedure thyroid-stimulating hormone (TSH) levels.
- Analysis of risk factors for patients with abnormal thyroid studies.
Main Results:
- Of 155 patients receiving ICM, 110 had TSH testing. Only 1.8% showed persistently elevated TSH, with pre-existing risk factors identified.
- Thyroid studies were completed in 113 patients; 61.1% were within the recommended 3-week FDA timeframe.
- Post-procedure thyroid studies were not completed in 27.1% of cases.
Conclusions:
- No clinically significant relationship was observed between ICM exposure and thyroid dysfunction in pediatric patients under four.
- Routine post-catheterization thyroid screening may not be necessary for this age group.
- Further research could explore specific high-risk subgroups if indicated.
Objectives:
To determine the incidence and severity of thyroid dysfunction following iodinated contrast media (ICM) exposure in our pediatric heart center, assess adherence to FDA guidelines and evaluate the utility of routine thyroid function testing.
Methods:
This retrospective study reviewed charts of 186 patients under four years old who underwent cardiac catheterization between June 2022 and June 2024 at our pediatric heart center. Data collected included age, sex, gestational age, ethnicity, ICM use, and post-procedure thyroid-stimulating hormone (TSH) levels. Additional risk factors were assessed for patients with abnormal thyroid studies.
Results:
Of the 186 cardiac catheterization procedures, 155 involved administration of ICM. Follow-up thyroid studies were conducted after 113 of these; three lab draws were excluded due to new diagnoses of hypothyroidism made during the study period. Among the remaining 110 cases with indicated TSH testing, only two patients (1.8 %) demonstrated persistently elevated TSH levels - both of whom had pre-existing risk factors for thyroid dysfunction. Among the 113 cases that completed follow-up TSH studies, 69 (61.1 %) occurred within the FDA's recommended 3-week period. Post-procedure thyroid studies were not completed in 42 cases (27.1 %), although four patients had passed away and four were transferred to another hospital system.
Conclusions:
No clinically significant relationship was found between ICM exposure and thyroid dysfunction in patients under four years old, suggesting routine post-catheterization thyroid screening may be unnecessary.
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Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...