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Iodinated contrast media exposure increases hypothyroidism risk in children
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Children exposed to iodinated contrast media during routine diagnostic imaging studies are at an increased risk for incident hypothyroidism, according to recent study findings.
In a case-control study, Meaghan L. Barr, a medical student at the UCLA David Geffen School of Medicine in Los Angeles, and colleagues analyzed medical records from pediatric patients with a diagnosis of hypothyroidism or available laboratory serum thyroid function test results within the UCLA health care system between 2001 and 2015 (870 cases; 870 controls; 64% girls; 51% white). Researchers defined iodinated contrast media exposure as the earliest date of administration within 2 years preceding the diagnosis date of hypothyroidism or hyperthyroidism. Patients were matched 1:1 on basis of age, sex and race; researchers used a conditional logistic regression model to estimate ORs of thyroid dysfunction after iodinated contrast media exposure.
Meaghan L. Barr
Within the cohort, 69 patients received iodinated contrast media, including 53 (6%) among cases and 16 (2%) among controls; 84% of patients with incident thyroid dysfunction developed hypothyroidism.
Patients exposed to iodinated contrast media had a higher risk for incident hypothyroidism (OR = 2.6; 95% CI, 1.43-4.72). Median time between exposure and incident hypothyroidism was 10.8 months. Among the hypothyroid cases exposed to iodinated contrast media with an available thyroid-stimulating hormone measurement, median serum concentration was 6.5 mIU/L.
A single dose of iodinated contrast media contains approximately 13,500 µg free iodine, according to study background; recommended daily iodine intake for children aged 1 to 8 years is 90 µg daily. Researchers found the most common sources of iodinated contrast exposure were from CT scans of the abdomen or pelvis with IV contrast, followed by CT chest scans and urethrocystograms.
“This study suggests that children receiving iodinated contrast media should be monitored for iodine-induced thyroid dysfunction, particularly in the first year after exposure,” Barr told Endocrine Today. “Further areas of research may include assessment of comorbidities that predispose to thyroid dysfunction, as well as assessment of duration of thyroid dysfunction following iodinated contrast media exposure.” – by Regina Schaffer
For more information:
Meaghan L. Barr can be reached at the UCLA David Geffen School of Medicine, 10833 Le Conte Ave., Los Angeles, CA 90095; email: meaghanbarr@mednet.ucla.edu.
Disclosure: The researchers report no relevant financial disclosures.
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