The effect of iodinated contrast media on thyroid (dys)function in children

Area of Science:

• Pediatric Endocrinology
• Radiology
• Thyroidology

Background:

• Iodinated contrast media (ICM) contain excess iodine, posing a risk for thyroid dysfunction.
• Children, especially neonates and premature infants, are more susceptible due to immature thyroid physiology.

Purpose of the Study:

• To systematically review the effects of ICM on thyroid function in pediatric patients.
• To identify vulnerable pediatric populations at higher risk for ICM-induced thyroid dysfunction.

Main Methods:

• A systematic review of multiple databases (Embase, Medline, Cochrane, Web of Science, Scopus) was performed.
• Studies included children up to 18 years old who received ICM and had thyroid function reported.
• Exclusion criteria focused on non-relevant exposures and endpoints to ensure study quality.

Main Results:

• Temporary thyroid function disturbances, primarily subclinical hypothyroidism, were common after ICM exposure in children.
• Overt hypothyroidism and thyrotoxicosis were rare but reported, mainly in neonates and high-risk infants.
• TSH abnormalities were observed in up to 25% of neonates, with some requiring treatment.

Conclusions:

• ICM exposure can induce thyroid dysfunction in children, with neonates and preterm infants being particularly vulnerable.
• Risk-based screening and monitoring are crucial for timely diagnosis and management of thyroid dysfunction post-ICM.
• Proactive thyroid function assessment can prevent complications in at-risk pediatric patients.