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July 1984, Vol 138, No. 7 >
Article | July 1984

Thyroid Function Changes FREE

KENNETH G. ROTHWELL, MD
Am J Dis Child. 1984;138(7):700-701. doi:10.1001/archpedi.1984.02140450082027.
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Sir.—In a report by Lyen and associates1 in AJDC, a male neonate was described in whom the serum thyroxine (T4) and thyroid-stimulating concentrations underwent an interesting sequence of changes during the first two months of life; they ascribed these changes to prolonged exposure to povidone-iodine solution. In this letter, I point out why exposure to iodine was almost certainly not necessarily the only cause of the observed changes in serum thyroid-related hormone concentrations, and I suggest an alternate explanation for them.

The newborn in the study by Lyen et al1 underwent a laparotomy on his third day of life for possible necrotizing entercolitis. The descending colon was found to be perforated, and an ileostomy was performed. Five days later (day 8), the abdominal wound broke down, and on the tenth day of life, a 56-day series of daily washes of the wound with povidone-iodine was started.

REFERENCES

1 +
Lyen KR, Finegold D, Orsini R, et al:  Transient thyroid suppression associated with topically applied povidone-iodine . AJDC 1982;;136:369-370.
2 +
Braverman LE, Woeber KA, Ingbar SH:  Induction of myxedema by iodide in euthyroid patients following radioiodine or surgical treatment of diffuse toxic goiter . N Engl J Med 1969;;281:816-821.
3 +
Braverman LE, Ingbar SH, Vagenakis AG, et al:  Enhanced susceptibility to iodide myxedema in patients with Hashimoto's disease . J Clin Endocrinol Metabol 1971;;32:515-521.
4 +
Wartofsky LW, Burman KD:  Alterations in thyroid function in patients with systemic illness: The 'euthyroid sick syndrome.' Endocr Rev 1982;;3:164-217.
5 +
Fisher DA, Klein AH:  Thyroid development and disorders of thyroid function in the newborn . N Engl J Med 1981;;304:702-712.
6 +
Bacci V, Schussler GC, Kaplan TB:  The relationship between serum triiodothyronine and thyrotropin during systemic illness . J Clin Endocrinol Metabol 1982;;54:1229-1235.

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References

1 +
Lyen KR, Finegold D, Orsini R, et al:  Transient thyroid suppression associated with topically applied povidone-iodine . AJDC 1982;;136:369-370.
2 +
Braverman LE, Woeber KA, Ingbar SH:  Induction of myxedema by iodide in euthyroid patients following radioiodine or surgical treatment of diffuse toxic goiter . N Engl J Med 1969;;281:816-821.
3 +
Braverman LE, Ingbar SH, Vagenakis AG, et al:  Enhanced susceptibility to iodide myxedema in patients with Hashimoto's disease . J Clin Endocrinol Metabol 1971;;32:515-521.
4 +
Wartofsky LW, Burman KD:  Alterations in thyroid function in patients with systemic illness: The 'euthyroid sick syndrome.' Endocr Rev 1982;;3:164-217.
5 +
Fisher DA, Klein AH:  Thyroid development and disorders of thyroid function in the newborn . N Engl J Med 1981;;304:702-712.
6 +
Bacci V, Schussler GC, Kaplan TB:  The relationship between serum triiodothyronine and thyrotropin during systemic illness . J Clin Endocrinol Metabol 1982;;54:1229-1235.

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