{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:34Z","timestamp":1756339534895,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,27]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>A neonate, born at 24 weeks, underwent a patent ductus arteriosus ligation, with previous normal thyroid stimulating hormone (TSH) levels, developed severe hypothyroidism from topical exposure to iodine following a single surgical procedure at 28 days of life. A low free T4 level of 0.05\u2009ng\/dL and a high TSH level of 228 mIU\/L was detected with an increased urinary iodine excretion level of 178\u2009mg\/L (reference range 0.30\u20131.97\u2009mg\/L). The thyroid ultrasound was normal. Levothyroxine was started immediately but thyroid function did not recover fully during admission and levothyroxine was required beyond term corrected. This case highlighted how susceptible extremely preterm infants are to iodine induced hypothyroidism, even short-term topical exposure. Delayed treatment of hypothyroidism can lead to profound neurodevelopmental delay. As surgical advances allow for interventions at earlier gestations, the importance of early thyroid function testing postexposure to iodine is highlighted and ultimately topical iodine should be avoided in these susceptible infants.<\/jats:p>","DOI":"10.1136\/bcr-2020-240006","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T11:07:11Z","timestamp":1614337631000},"page":"e240006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Severe hypothyroidism following a single topical exposure to iodine in a premature neonate"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6621-5587","authenticated-orcid":false,"given":"Catherine Mary","family":"Breen","sequence":"first","affiliation":[{"name":"Department of Neonatology, Rotunda Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Fahim","family":"Salama","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Rotunda Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A","family":"Boyle","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Rotunda Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"2025082709023536000_14.2.e240006.1","first-page":"138","article-title":"Patent ductus arteriosus: an overview","volume":"12","author":"Dice","year":"2007","journal-title":"J Pediatr Pharmacol Ther"},{"key":"2025082709023536000_14.2.e240006.2","doi-asserted-by":"publisher","DOI":"10.1159\/000358198"},{"key":"2025082709023536000_14.2.e240006.3","doi-asserted-by":"publisher","DOI":"10.4274\/jcrpe.v1i6.275"},{"key":"2025082709023536000_14.2.e240006.4","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1995.02170250042006"},{"key":"2025082709023536000_14.2.e240006.5","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S0021-9258(18)57335-X","article-title":"Plasma inorganic iodide as a homeostatic regulator of thyroid function","volume":"174","author":"Wolff","year":"1948","journal-title":"J Biol Chem"},{"key":"2025082709023536000_14.2.e240006.6","doi-asserted-by":"crossref","first-page":"3585","DOI":"10.1210\/jc.2018-00960","article-title":"Early identification of primary hypothyroidism in neonates exposed to intralymphatic iodinated contrast: a case series","volume":"103","author":"Cherella","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082709023536000_14.2.e240006.7","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1515\/jpm-2016-0141","article-title":"Thyroid dysfunction in preterm neonates exposed to iodine","volume":"45","author":"Williams","year":"2017","journal-title":"J Perinat Med"},{"key":"2025082709023536000_14.2.e240006.8","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/S0140-6736(89)90903-3","article-title":"Topical iodine-containing antiseptics and neonatal hypothyroidism in very-low-birthweight infants","volume":"2","author":"Smerdely","year":"1989","journal-title":"Lancet"},{"key":"2025082709023536000_14.2.e240006.9","first-page":"620","article-title":"[Transient hypothyroidism in 8 low birth weight newborns. 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