Skip to main content
Log in

Voiding cystography: an unusual route of induced hypothyroidism by iodine overdose in two newborns with chronic kidney disease

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Iatrogenic induced hypothyroidism had been described in newborns and more particularly in preterm infants after cutaneous or intravenous exposure to iodine.

Case-diagnosis 

We reported a new risk of iodine intoxication with the cases of two newborns who developed hypothyroidism after intra vesical iodine injection during a cystography, which was performed to confirm antenatal diagnosis of posterior urethral valves (PUV). The newborns both developed transient hypothyroidism due to an iodine overdose.

Conclusions

These two observations suggest that voiding cystourethrography (VCUG) should be carefully considered in newborns with severe uropathy, particularly in the case of renal insufficiency. If indicated, thyroid function should be monitored in the following weeks, and in case of hypothyroidism treatment should be started.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wassner AJ, Brown RS (2015) Congenital hypothyroidism: recent advances. Curr Opin Endocrinol Diabetes Obes 22:407–412

    Article  CAS  PubMed  Google Scholar 

  2. Leung AM, Braverman LE (2014) Consequences of excess iodine. Nat Rev Endocrinol 10:136–142

    Article  CAS  PubMed  Google Scholar 

  3. Sanai T, Okamura K, Rikitake S, Fukuda M, Onozawa K, Sanematsu M, Takashima T, Miyazono M, Ikeda Y (2017) The high prevalence of reversible subclinical hypothyroidism with elevated serum thyroglobulin levels in chronic kidney disease patients. Clin Nephrol 87:237–244

    Article  CAS  PubMed  Google Scholar 

  4. Wolff J, Chaikoff IL (1948) Plasma inorganic iodide as a homeostatic regulator of thyroid function. J Biol Chem 174:555–564

    CAS  PubMed  Google Scholar 

  5. Eng PH, Cardona GR, Fang SL, Previti M, Alex S, Carrasco N, Chin WW, Braverman LE (1999) Escape from the acute Wolff-Chaikoff effect is associated with a decrease in thyroid sodium/iodide symporter messenger ribonucleic acid and protein. Endocrinology 140:3404–3410

    Article  CAS  PubMed  Google Scholar 

  6. Leung AM, Braverman LE (2012) Iodine-induced thyroid dysfunction. Curr Opin Endocrinol Diabetes Obes 19:414–419

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Brough R, Jones C (2006) Iatrogenic iodine as a cause of hypothyroidism in infants with end-stage renal failure. Pediatr Nephrol 21:400–402

    Article  PubMed  Google Scholar 

  8. Ares S, Pastor I, Quero J, Morreale de Escobar G (1995) Thyroid complications, including overt hypothyroidism, related to the use of non-radiopaque silastic catheters for parenteral feeding in prematures requiring injection of small amounts of an iodinated contrast medium. Acta Paediatr 84:579–581

    Article  CAS  PubMed  Google Scholar 

  9. Thaker VV, Galler MF, Marshall AC, Almodovar MC, Hsu H-W, Addis CJ, Feldman HA, Brown RS, Levine BS (2017) Hypothyroidism in infants with congenital heart disease exposed to excess iodine. J Endocr Soc 1:1067–1078

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Barr ML, Chiu HK, Li N, Yeh MW, Rhee CM, Casillas J, Iskander PJ, Leung AM (2016) Thyroid dysfunction in children exposed to iodinated contrast media. J Clin Endocrinol Metab 101:2366–2370

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Bernardes LS, Aksnes G, Saada J, Masse V, Elie C, Dumez Y, Lortat-Jacob SL, Benachi A (2009) Keyhole sign: how specific is it for the diagnosis of posterior urethral valves? Ultrasound Obstet Gynecol 34:419–423

    Article  CAS  PubMed  Google Scholar 

  12. Duran C, del Riego J, Riera L, Martin C, Serrano C, Palaña P (2012) Voiding urosonography including urethrosonography: high-quality examinations with an optimised procedure using a second-generation US contrast agent. Pediatr Radiol 42:660–667

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Laure Cohen.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cohen, L., Pouletty, M., Frerot, A. et al. Voiding cystography: an unusual route of induced hypothyroidism by iodine overdose in two newborns with chronic kidney disease. Pediatr Nephrol 34, 1295–1297 (2019). https://doi.org/10.1007/s00467-019-04247-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-019-04247-1

Keywords

Navigation