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Pediatrics ; 137(4)2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-27006474

RESUMO

A 27-year-old gravid 1 at 27 weeks 6 days with a history of hypothyroidism had an ultrasound that demonstrated a 3.9 × 3.2 × 3.3-cm well-circumscribed anterior neck mass, an extended fetal head, and polyhydramnios. Further characterization by magnetic resonance imaging (MRI) showed a fetal goiter. During her evaluation for the underlying cause of the fetal goiter, the patient revealed she was taking nutritional iodine supplements for treatment of her hypothyroidism. She was ingesting 62.5 times the recommended amount of daily iodine in pregnancy. The excessive iodine consumption caused suppression of the fetal thyroid hormone production, resulting in hypothyroidism and goiter formation. After the iodine supplement was discontinued, the fetal goiter decreased in size. At delivery, the airway was not compromised. The infant was found to have reversible hypothyroidism and bilateral hearing loss postnatally. This case illustrates the importance of examining for iatrogenic causes for fetal anomalies, especially in unregulated nutritional supplements.


Assuntos
Doenças Fetais/induzido quimicamente , Bócio/induzido quimicamente , Perda Auditiva/induzido quimicamente , Hipotireoidismo/tratamento farmacológico , Iodo/efeitos adversos , Complicações na Gravidez/tratamento farmacológico , Adulto , Feminino , Doenças Fetais/diagnóstico por imagem , Humanos , Recém-Nascido , Iodo/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Exposição Materna , Gravidez , Diagnóstico Pré-Natal , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/embriologia , Tireotropina/sangue , Ultrassonografia
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