Maternal Iodine Exposure: A Case of Fetal Goiter and Neonatal Hearing Loss

Overcash, Rachael T.; Marc-Aurele, Krishelle; Hull, Andrew; Ramos, Gladys A.

doi:10.1542/peds.2015-3722

Cited by 23 publications

(25 citation statements)

References 12 publications

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“…Our patient is similar to one recently presented in a case report by Overcash et al [40] in which the mother was also taking 50 times the dose of iodine recommended in pregnancy, resulting in a fetal goiter, with discontinuation of the supplements at 29 weeks’ gestation. However, in that case, the patient was not treated with intra-amniotic levothyroxine injections.…”

Section: Discussionsupporting

confidence: 87%

Iodine-Induced Fetal Hypothyroidism: Diagnosis and Treatment with Intra-Amniotic Levothyroxine

et al. 2018

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Background: Iodine is necessary for fetal thyroid development. Excess maternal intake of iodine can cause fetal hypothyroidism due to the inability to escape from the Wolff-Chaikoff effect in utero. Case Report: We report a case of fetal hypothyroid goiter secondary to inadvertent excess maternal iodine ingestion from infertility supplements. The fetus was successfully treated with intra-amniotic levothyroxine injections. Serial fetal blood sampling confirmed fetal escape from the Wolff-Chaikoff effect in the mid third trimester. Early hearing test and neurodevelopmental milestones were normal. Conclusion: Intra-amniotic treatment of fetal hypothyroidism may decrease the rate of impaired neurodevelopment and sensorineural hearing loss.

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Section: Discussionsupporting

confidence: 87%

Iodine-Induced Fetal Hypothyroidism: Diagnosis and Treatment with Intra-Amniotic Levothyroxine

et al. 2018

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“…Although capable of iodine organification starting from 16 to 20 gestational weeks, the developing fetal thyroid may not be able to escape from the Wolff−Chaikoff effect until about 36 weeks . Sequelae due to maternal−fetal excess iodine exposure include, in severe cases, fetal goiter that can obstruct the neonatal airway at delivery, or congenital hypothyroidism . Although most reported cases have been due to medications, supplements, or seaweed, in some individuals even mildly excessive maternal intakes may cause maternal hypothyroidism or isolated hypothyroxinemia, and this could potentially affect cognitive development of the offspring …”

Section: Vulnerable Groupsmentioning

confidence: 99%

Excess iodine intake: sources, assessment, and effects on thyroid function

Farebrother

Zimmermann

Andersson

2019

Annals of the New York Academy of Sciences

191

131

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Iodine is essential for thyroid hormone synthesis. High iodine intakes are well tolerated by most healthy individuals, but in some people, excess iodine intakes may precipitate hyperthyroidism, hypothyroidism, goiter, and/or thyroid autoimmunity. Individuals with preexisting thyroid disease or those previously exposed to iodine deficiency may be more susceptible to thyroid disorders due to an increase in iodine intake, in some cases at intakes only slightly above physiological needs. Thyroid dysfunction due to excess iodine intake is usually mild and transient, but iodine‐induced hyperthyroidism can be life‐threatening in some individuals. At the population level, excess iodine intakes may arise from consumption of overiodized salt, drinking water, animal milk rich in iodine, certain seaweeds, iodine‐containing dietary supplements, and from a combination of these sources. The median urinary iodine concentration (UIC) of a population reflects the total iodine intake from all sources and can accurately identify populations with excessive iodine intakes. Our review describes the association between excess iodine intake and thyroid function. We outline potential sources of excess iodine intake and the physiological responses and consequences of excess iodine intakes. We provide guidance on choice of biomarkers to assess iodine intake, with an emphasis on the UIC and thyroglobulin.

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“…It can adjust many genes and proteins expression of the auditory pathway. Thyroid hormone deficiency may lead to not only the hearing loss of human and mouse, 11 , 12 , 13 be associated with inner ear diseases, such as Meniere's disease, 14 but also play an important role in the mechanism of deafness caused by SLC26A4 mutations. 15 In recent years, the proportion of patients with thyroid dysfunction in SSHL has been increasing, which has gradually attracted the attention of otologists.…”

Section: Discussionmentioning

confidence: 99%

Analysis of thyroid dysfunction in patients with sudden sensorineural hearing loss

Zhu

Dai

Wang

et al. 2021

World j. otorhinolaryngol.-head neck surg.

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Background Sudden sensorineural hearing loss (SSHL) refers to the sudden occurrence of unexplained sensorineural hearing loss. The present study showed that different systemic diseases had different influence on the occurrence and hearing outcome of SSHL. Thyroid hormone is one of the important factors for the development of fetal ear and auditory function. However, the distribution of thyroid dysfunction in SSHL patients and the effect of thyroid dysfunction on the occurrence and hearing outcome of SSHL has not been studied. Methods In this study, a retrospective analysis had been done in 676 patients with SSHL. We had described the distribution of thyroid function in patients with SSHL in detail, and by the statistical method, analyzed the relationship between the hearing outcome and thyroid dysfunction, respectively. Results In all patients, 24.41% (165/676) had abnormal thyroid function testing results. The onset age of SSHL in FT3 abnormal group (including low and high group) was younger than that in normal FT3 group. Recovery group had more patients with lower-than-normal T3 level as compared to non-recovery patients. Significant associations between T3 levels and hearing outcome were observed in the subgroup with longer time elapse between symptom onset and treatment (≥14 d). Conclusion The incidence of thyroid dysfunction in SSHL is significantly higher than in the general population. There was obvious relationship between T3 and FT3 item of thyroid dysfunction and the onset time and hearing outcome of SSHL, which indicated that T3 or FT3 indicator may be one of the affecting factors for the SSHL. Early screening and diagnosis of thyroid dysfunction, especial T3 level, may help to evaluate the prognosis in SSHL patients.

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Maternal Iodine Exposure: A Case of Fetal Goiter and Neonatal Hearing Loss

Cited by 23 publications

References 12 publications

Iodine-Induced Fetal Hypothyroidism: Diagnosis and Treatment with Intra-Amniotic Levothyroxine

Iodine-Induced Fetal Hypothyroidism: Diagnosis and Treatment with Intra-Amniotic Levothyroxine

Excess iodine intake: sources, assessment, and effects on thyroid function

Analysis of thyroid dysfunction in patients with sudden sensorineural hearing loss

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