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  • Title: Topical Iodine-Induced Thyrotoxicosis in a Newborn with a Giant Omphalocele.
    Author: Malhotra S, Kumta S, Bhutada A, Jacobson-Dickman E, Motaghedi R.
    Journal: AJP Rep; 2016 Apr; 6(2):e243-5. PubMed ID: 27551578.
    Abstract:
    INTRODUCTION: Neonatal thyrotoxicosis is a life-threatening condition with potentially irreversible neurologic sequelae. Most cases are seen in neonates born to mothers with Graves' disease. Topical iodine-induced hypothyroidism has been reported in neonates, but iodine-induced neonatal hyperthyroidism has not been described; albeit a familiar entity in adults. CASE DESCRIPTION: Herein we present a unique case of a neonate, born with a giant omphalocele, who was treated with topical povidone-iodine dressings to promote escharification, in preparation for delayed surgical closure. By third day of life (DOL), the baby presented with a suppressed thyroid stimulating hormone of 0.59 µIU/mL, elevated free thyroxine of 5.63 ng/dL, and frank cardiovascular manifestations of thyrotoxicosis. After replacement of the topical iodine dressings with iodine-free silver sulfadiazine, the thyroid status gradually improved with complete resolution of hyperthyroidism by 17th DOL. CONCLUSION: This case emphasizes that significant topical iodine exposure can result in both hypothyroidism and hyperthyroidism, and therefore, vigilance in monitoring thyroid function is imperative.
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