Neonatal goiter

Neonatal goiter caused by the use of potassium iodine as an expectorant during pregnancy has been reported (67). The neonate, a girl, had acute hypothyroidism, with myxedema and respiratory distress. She was given levothyroxine for 6 months, with complete normalization of thyroid function. 

Bostanci I, Sarioglu A, Ergin H, Aksit A, Cinbis M, Akalin N. Neonatal goiter caused by expectorant usage. J Pediatr Endocrinol Metab 2001 14(8) 1161-2. 

Neonate Neonatal goiter Neonatal hypothyroidism Endemic mental retardation Increased susceptibility of the thyroid gland to nuclear radiation... 

Refetoff S, Ochi Y, Selenkow HA, Rosenfield RL. Neonatal hypothyroidism and goiter in one infant of each of two sets of twins due to maternal therapy with antithyroid drugs. J Pediatr 1974 85(2) 240-4. 

The major adverse effect on the fetus is altered thyroid function (SEDA-13, 141 SEDA-14, 149 SEDA-19, 194 SEDA-20, 176). There have been individual reports of neonatal hyperthyroxinemia (79), goiter (80), and hypothyroidism (81). In the patient with goiter there was associated hypotonia, bradycardia, large fontanelles, and macroglossia (80). 

M. Goiter and I.A. Michaelson, Growth, behavior, and brain catecholamines in lead-exposed neonatal rats A reappraisal, Science, 187 (1975) 359-361. 

Congenital goiter and neonatal hypothyroidism may occur if thiouracil drugs are administered during pregnancy (12). 

Neonates born to mothers taking lithium included a boy with a goiter and chemical hypothyroidism who required temporary treatment with oral thyroxine for 11 weeks... 

Iodine-induced goiter Iodine-induced hypothyroidism Fetus and neonate... 

Include tremor, ataxia, choreoathetosis, acne, edema, visual dysfunction, seizures, goiter, and hypothyroidism via inhibition of 5 deiodinase nephrogenic diabetes insipidus via uncoupling of vasopressin V2 receptors (treat with amiloride, not thiazides) teratogenicity (cardiac malformations, neonatal cyanosis, and hepatomegaly). 

Long-term therapy is contraindicated, because iodides will cross the placenta and into breast milk, causing hypothyroidism (goiter) in the fetus and neonate. Short, intensive therapy for thyrotoxic crisis may be utilized without adverse effects to the fetus. 

The observations relating to iodine deficiency in pregnancy are firstly those concerned with maternal thyroid function and maternal goiter. Maternal urinary iodine (UI) excretion is the usual method of assessing iodine status in the population at risk or the individual, and is discussed below. Neonatal indicators of maternal iodine deficiency are goiter and neurointellectual impairment. 

Another important group, the National IDD Advisory Committee (NIDDAC) chaired by Professor Chen Zupei, has played a crucial role in the national program. Under the leadership of the MOH, NIDDAC provides scientific and technical guidefines, standards and recommendations. It also provides evidence for poficy development (IDD Newsletter, 1998). Since 1993 NIDDAC has re-evaluated and standardized the measmement of thyroid gland size by palpation and ultrasound standardized urinary iodine testing methods. It has also evaluated the technical aspects and the application of neonatal TSH in IDD monitoring, iodine excess and excessive dietary iodine-induced goiter, and the role of iodized oil in the prevention and control of IDD and iodine-induced hyperthyroidism (Chen, 2002). 

Gonsumption of large amounts of kelp has been found to be associated with thyroid disorders, such as goiter, hypothyroidism alone or in combination with thyroid enlargement, Hashimoto s thyroiditis and neonatal hypothyroidism. Studies showing a decrease in goiter size... 

The fetus and neonate are both at risk of developing iodine-induced hypothyroidism (Table 96.3). Many cases of such hypothyroidism in fetuses and neonates have been reported, especially in iodine-deficient regions of Europe, but also in iodine-sufficient areas. Iodide goiter in neonates is usually a transient problem. However, tracheal obstruction due to such goiter can be fatal (Markou et al, 2001 Wolff, 1969). Transient hypothyroidism without elevation of thyroid-stimulating hormone (TSH) in extremely... 

Mandating periodic cohort surveys for tracking the disappearance of IDD by assessments of goiter, urinary iodine, neonatal total goiter prevalence and other relevant indicators. 

Table 121.1 Neonatal TSH 97% cut-off, goiter prevalence and urinary iodine excretion in different areas of Calabria...

Areas Neonatal TSH 97% cut-off (nU/nnl) Goiter prevalence (%>) Median urinary iodine excretion (pg/i)... 

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