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Thyroid Dysfunction in Children Exposed to Iodinated Contrast Media.

  • Author(s): Barr, Meaghan L;
  • Chiu, Harvey K;
  • Li, Ning;
  • Yeh, Michael W;
  • Rhee, Connie M;
  • Casillas, Jacqueline;
  • Iskander, Paul J;
  • Leung, Angela M
  • et al.
Abstract

Context

Iodinated contrast media (ICM) is routinely used in imaging studies and contains several 100-fold the recommended daily allowance of iodine.

Objective

To determine whether children exposed to ICM have a higher risk of iodine-induced thyroid dysfunction.

Design

This was a single-institution case-control study, examining patients with incident thyroid dysfunction aged less than 18 years from 2001 to 2015. Cases were matched 1:1 to euthyroid controls by age, sex, and race.

Setting

This was a single-institution case-control study occurring at tertiary care center.

Participants

Cases were defined as those with thyroid dysfunction (by International Classification of Diseases, Ninth Revision diagnosis codes and/or 2 consecutive abnormal serum TSH values <6 mo apart). We analyzed 870 cases matched to 870 controls (64% female, 51% White).

Main outcomes measures

Using conditional logistic regression, the association between ICM exposure and the primary outcome, thyroid dysfunction, occurring within 2 years of exposure was assessed.

Results

Sixty-nine patients received ICM, including 53 (6%) among cases and 16 (2%) among controls. The risk of incident hypothyroidism was significantly higher after ICM exposure (odds ratio 2.60; 95% confidence interval, 1.43-4.72; P < .01). The median interval between exposure and onset of hypothyroidism was 10.8 months (interquartile range, 6.6-17.9). In hypothyroid cases, the median serum TSH concentration was 6.5 mIU/L (interquartile range, 5.8-9.6).

Conclusions

ICM exposure increases the risk of incident hypothyroidism in pediatric patients. Children receiving ICM should be monitored for iodine-induced thyroid dysfunction, particularly during the first year after exposure.

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