Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption

Leide-Svegborn, Sigrid; Ahlgren, Lars; Johansson, Lennart; Mattsson, Sören

doi:10.1007/s00259-015-3286-0

Cited by 33 publications

(34 citation statements)

References 37 publications

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“…A 12-hour interruption has also been recommended for I-iodo-hippurate [3]. The %ID in breast milk is higher for Tc-labelled compounds (<0.1 %).…”

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confidence: 99%

“…Unfortunately, the study by Leide-Svegborn et al [3] Tc-pertechnetate in breast milk is the presence of a sodium iodide symporter in mammary gland cells [7], which leads to a significantly higher radioactivity concentration in breast milk than in maternal plasma. The study by Leide-Svegborn et al [3] showed a lower excretion of radioactivity in breast milk after pretreatment with the thyroid blocking agent perchlorate: after 99m Tc-pertechnetate administration without blocking a 10 %ID in breast milk was found compared with a significantly lower 0.82 %ID with blocking. These data are supported by animal data from mouse mammary gland cells which also show blocking of the sodium iodide symporter by perchlorate [7].…”

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confidence: 99%

“…This is in accordance with the findings of other studies [8,9] and indicates a lower radiostability of this radiopharmaceutical. LeideSvegborn et al [3] found a %ID between 2.0 and 2.4 for radioiodine-labelled hippurate, which led to higher expected radiation absorbed doses of 1.0 mSv infant /MBq mother for 125 Iiodo-hippurate and 5.3 mSv infant /MBq mother for 131 I-iodohippurate. These results are in line with data reported by Rose et al [6] showing radioactivity concentrations in breast milk of 1.2 % to 4.9 % for The longest mandatory interruption of breastfeeding is associated with the administration of 131 I-NaI for which an interruption of at least 3 weeks is necessary.…”

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confidence: 99%

“…In this issue of the journal, Leide-Svegborn et al [3] report data on radioactivity concentrations in breast milk from 53 breastfeeding patients. Their study included one of the largest populations of breastfeeding women studied.…”

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confidence: 99%

“…However, with respect to the radiation exposure to the mother, close body contact between mother and child should be avoided to ensure that the dose to the infant does not exceed 1 mSv [4]. The study by Leide-Svegborn et al [3] Tc-labelled substances, however, a 4-hour interruption (equivalent to one discarded meal) will ensure that the infant is exposed to only a low absorbed dose from free 99m Tcpertechnetate in the radiopharmaceuticals given to the mother. Fortunately, the radiostability of these 99m Tc-labelled compounds is high and the radiolabelling process shows a high binding efficiency of >95 %.…”

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confidence: 99%

See 4 more Smart Citations

Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption

Liepe

Becker

2016

Eur J Nucl Med Mol Imaging

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“…A 12-hour interruption has also been recommended for I-iodo-hippurate [3]. The %ID in breast milk is higher for Tc-labelled compounds (<0.1 %).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption

Liepe

Becker

2016

Eur J Nucl Med Mol Imaging

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Teratogen update: Antithyroid medications

Romeo

Običan

2020

Birth Defects Research

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Objective Thyroid disorders including hyperthyroidism are common during pregnancy. Untreated hyperthyroidism can result in adverse outcomes for pregnancy. Methods Iodine, propylthiouracil (PTU), carbimazole (CMZ), and methimazole (MMI) are common medications for hyperthyroidism treatment. The literature regarding antithyroid medication use in pregnancy and breastfeeding is reviewed. Results Animal studies for PTU have suggested congenital anomalies while animal studies for MMI have only indicated adverse outcomes at higher doses than used in humans. Epidemiological studies have noted an increased risk of congenital anomalies for PTU less often than CMZ or MMI but the epidemiological evidence remains mixed. A pattern of anomalies has been described for CMZ and MMI, from both case and epidemiological studies, including choanal atresia, aplasia cutis congenita, and other facial, heart, gastrointestinal, and skin anomalies. Closer examination of cases indicates that a few cases of the anomalies have occurred without exposure to CMZ or MMI and outside of the proposed critical period. PTU has a small risk of hepatotoxicity which rarely results in liver transplantation and death. Some authors have suggested that PTU be prescribed in early pregnancy and switched to MMI in late pregnancy. Untreated hyperthyroidism, from either a lack of medications or switching medications during the first trimester, may also increase the chance of congenital anomalies. Multiple case studies and larger epidemiological studies have failed to provide clear, consistent outcomes for the use of PTU, CMZ, and MMI in pregnancy. MMI and PTU both enter the breastmilk in small amounts. Conclusion Additional research is needed to assist in the medical management and exposure counseling of pregnant and breastfeeding women with hyperthyroidism.

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