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两名日本婴儿在暴露于含的对比介质后患有甲状腺功能低下症
Kazuhiro Shimura1, Hironori Shibata1,2, Tomonobu Hasegawa1
1Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan.
JCEM case reports
|November 1, 2023
概括
含有的对比介质 (ICM) 暴露可能会导致婴儿暂时的甲状腺功能低下症,需要接受甲状腺素 (LT4) 治疗. 诸如早产和遗传倾向等危险因素可能会影响严重程度.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 放射学 放射学是一门学科.
- 新生儿科学 新生儿科学
背景情况:
- 化对比介质 (ICM) 广泛用于儿科成像.
- 新生儿和婴儿可能容易受到ICM暴露的不良影响.
- 甲状腺功能障碍是显著的负载后的潜在问题.
研究的目的:
- 报告ICM暴露后婴儿过渡性甲状腺功能低下症的病例.
- 突出需要监测对比增强程序后新生儿的甲状腺功能.
- 为了确定影响ICM诱导的甲状腺功能低下症的发展和严重程度的潜在风险因素.
主要方法:
- 两名日本婴儿患有先天性心脏病的案例报告.
- 暴露于有的对比介质,用于对比增强计算机断层扫描 (CT).
- 监测甲状腺刺激激素 (TSH) 和自由甲状腺素 (fT4) 水平,根据需要开始甲状腺素 (LT4) 替代疗法.
主要成果:
- 两名婴儿在ICM暴露后都发展出甲状腺功能低下症,需要LT4治疗.
- 患者1 (预期) 显示过渡性甲状腺功能低下症,而患者2 (全期) 需要治疗3年.
- 在患者1观察到的甲状腺缺血;患者2有一个DUOX2变体.
- 甲状腺功能低下症的严重程度似乎与早产,遗传倾向和暴露时间等因素有关.
结论:
- 暴露于ICM可能会诱导婴儿的过渡性甲状腺功能低下症,需要接受levothyroxine (LT4) 治疗.
- 诸如遗传背景,早产,甲状腺结构和早期ICM暴露等因素影响甲状腺功能低下症的严重程度.
- 密切监测甲状腺功能对于暴露于ICM的婴儿至关重要,特别是那些有风险因素的婴儿.
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