Related Experiment Videos
Hypothyroidism secondary to topical iodine treatment in infants with spina bifida
M Barakat1, D Carson, A M Hetherton
1Department of Child Health, Queens University, Belfast.
Insights
Topical iodine antiseptics, like Betadine, applied to spina bifida defects in infants can lead to hypothyroidism. Routine thyroid function monitoring is recommended during such treatments.
Area of Science:
- Neonatal care
- Endocrinology
- Pediatric surgery
Background:
- Spina bifida is a congenital condition requiring specialized care.
- Topical antiseptics are often used in managing myelomeningocele defects.
- Iodine-containing antiseptics pose a potential risk to thyroid function.
Purpose of the Study:
- To investigate the impact of topical iodine antiseptic on thyroid function in infants with spina bifida.
- To assess the incidence of hypothyroidism in infants treated with iodine-containing ointments.
Main Methods:
- Case series of four infants with spina bifida.
- Application of iodine-containing ointment (Betadine) to lumbar myelomeningocele defects.
- Monitoring of urinary iodine concentration, serum free thyroxine, and thyroid stimulating hormone levels.
Main Results:
- All infants exhibited elevated urinary iodine concentrations.
- Two infants developed subclinical hypothyroidism (low free thyroxine, high TSH) requiring thyroxine replacement.
- Thyroid function normalized after cessation of iodine treatment.
Conclusions:
- Topical iodine antiseptics can cause transient hypothyroidism in infants.
- Routine thyroid function monitoring is crucial for infants receiving topical iodine treatment.
- Discontinuation of iodine application leads to euthyroid state.
Abstract:
Four infants with spina bifida, who had not undergone surgical closure of a lumbar myelomeningocele, were assessed and investigated for hypothyroidism. From birth, all were treated once daily with an iodine-containing ointment (Betadine) as a local antiseptic applied to the spina defect. All infants showed excess urinary iodine concentration. Two infants, without clinical evidence of hypothyroidism or goitre, showed low serum free thyroxine and high thyroid stimulating hormone concentrations at a mean age of four weeks and were started on thyroxine replacement treatment. Betadine ointment and thyroxine were stopped simultaneously at a mean age of nine months, following which all infants remained euthyroid. Thyroid function tests should be monitored routinely if iodine is applied as a topical antiseptic to infants.