Hypothyroidism Due to Iodine Overload in Children Receiving Peritoneal Dialysis: A Report of 4 Cases.
Children who receive peritoneal dialysis (PD) are at increased risk for thyroid dysfunction. A rarely appreciated cause is iodine overload. We report 4 children who developed iodine overload and secondary hypothyroidism. All had kidney failure treated by PD. Each previously had normal thyroid function screening test results. At the time hypothyroidism was detected, the duration of PD ranged from 1 week to 27 months (median, 6 months). Three children had high thyrotropin values and all had high serum iodine levels. The sole source of iodine exposure in each child was a povidone-iodine-impregnated gauze in the sterile transfer set cap associated with PD. Iodine overload is a poorly appreciated problem associated with the provision of PD in infants and small children and can lead to thyroid dysfunction. Increased awareness among pediatric nephrologists should lead to the development of optimal monitoring and prevention recommendations.
American journal of kidney diseases : the official journal of the National Kidney Foundation
Iodine overload; PD caps; case report; children; end-stage renal disease (ESRD); growth delay; hypothyroidism; infants; pediatric; peritoneal dialysis (PD); povidone gauze; povidone iodine; thyroid-stimulating hormone (TSH); thyrotropin
Mannemuddhu, S., Morgans, H. A., Pekkucuksen, N., Warady, B. A., Shoemaker, L. R. Hypothyroidism Due to Iodine Overload in Children Receiving Peritoneal Dialysis: A Report of 4 Cases. American journal of kidney diseases : the official journal of the National Kidney Foundation 76, 889-892 (2020).