DR.Guttler’s Patient Thyroid Blog Post: Infants at risk for thyroid dysfunction after contrast dye testing.
1. 3,481 patients under 3 years of age who were exposed to ICM, thyroid dysfunction was reported in anywhere from 1% to 15% of the patients.
2. Those at high risk were patients with underlying cardiac issues since they typically require higher doses of contrast during CT imaging for catheterization.
3.These injections — currently there are six approved, including iodixanol (Visipaque), iohexol (Omnipaque), iopamidol (Isovue), iopromide (Ultravist), iothalamate meglumine (Conray), and ioversol (Optiray).
We are watching for any patient possible thyroid dysfuction.
FDA: Monitor Tots’ Thyroids After Receiving Contrast Dye
— Agency releases new recommendation as follow-up to 2015 warning
by Kristen Monaco, Staff Writer, MedPage Today March 30, 2022
Newborns and very young children should undergo thyroid monitoring in the weeks after undergoing certain medical imaging, the FDA announced.
In an update to a 2015 warning, the agency is newly recommending that newborns and children up to 3 years old undergo follow-up thyroid monitoring within 3 weeks after receiving injections of contrast media containing iodine — otherwise known as contrast or x-ray dye.
This new warning pertains to the entire class of iodinated contrast media (ICM) injections, which are commonly used for x-rays of blood vessels, joints, and organs, and some CT scans.
Following a review of new research, the FDA determined that these injections have the potential to lead to an underactive thyroid or a temporary decrease in thyroid hormone levels. Although this was a relatively uncommon occurrence, the agency recommended these possible thyroid conditions should be diagnosed and treated as early as possible to prevent future issues.
This is particularly true for the most vulnerable population in question: premature newborns, very low birth weight newborns, or children with underlying conditions such as cardiac issues that could raise the risk for other thyroid issues.
“If thyroid dysfunction is detected, treat and monitor thyroid function as clinically needed to avoid future cognitive and other developmental disabilities,” the FDA said in its recommendation to healthcare providers, suggesting these patients may require transient T4 replacement therapy.
The agency also advised parents and caregivers to keep in mind that newborns and young children often won’t show any visible signs of thyroid issues.
Underpinning this new warning, the FDA reviewed six studies that have been published after and five studies published prior to their initial 2015 alert.
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