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[Treatment of neonatal hyperthyroidism with calcium iopodate]
R Mariani1, A M Bertrand, A M Maillotte
1Service de pédiatrie, hôpital de Cimiez, Nice, France.
Insights
Calcium ipodate effectively treats neonatal hyperthyroidism in infants born to mothers with Grave's disease. This treatment rapidly normalized thyroid hormone levels and resolved symptoms in newborns.
Area of Science:
- Neonatal Endocrinology
- Pharmacology
Background:
- Neonatal hyperthyroidism poses treatment challenges, particularly in infants of mothers with Grave's disease.
- Calcium ipodate, an oral cholecystography agent, demonstrates potential in managing this condition by inhibiting T3 to T4 conversion and reducing thyroid hormone secretion.
Observation:
- Two neonates with hyperthyroidism received oral calcium ipodate combined with a beta-blocker.
- Treatment commenced on specific days of life (26-50 and 9-18) and involved 400 mg doses every three days.
Findings:
- Clinical symptoms of hyperthyroidism resolved within two days of treatment initiation.
- Circulating levels of triiodothyronine (T3) and thyroxine (T4) normalized within 2-5 days in both neonates.
Implications:
- Calcium ipodate presents a well-tolerated and effective therapeutic option for neonatal hyperthyroidism.
- Further controlled studies are warranted to confirm efficacy and explore the role of anti-TSH receptor antibodies in preventing relapse.
Background:
Treatment of hyperthyroidism in those neonates born to mothers with Grave's disease is difficult. Calcium ipodate, an agent for oral cholecystography, inhibits extra-thyroid conversion of T3 to T4 and diminishes thyroid secretion.
Case Reports:
Two neonates with clinical manifestations and biological findings of hyperthyroidism were given calcium ipodate orally, 400 mg every 3 days, from day 26 to 50 for the first patient and from day 9 to 18 for the second in association with a beta blocker. Clinical manifestations disappeared within 2 days and circulating levels of T3 and T4 were normalized within 2-5 days.
Conclusions:
This treatment was effective and well-tolerated in both patients and in three others previously reported; it should be confirmed in a larger number of patients and controlled by measuring levels of antibodies directed against thyrotropin-releasing hormone receptors in order to avoid relapse after cessation of treatment as seen in our second patient.