{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T01:22:38Z","timestamp":1776388958399,"version":"3.51.2"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title><jats:p>Iodine is an essential trace element for maintenance of normal thyroid function. Normal thyroid function is a prerequisite for neurocognitive development and growth in children. In the United States, iodine is not routinely added as a trace element in parenteral nutrition (PN). Our objective was to determine the prevalence of iodine deficiency and hypothyroidism in children on chronic PN.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>This was a cross-sectional study of children &amp;lt;17 years of age and using PN for &amp;gt;6 months at a tertiary children\u2019s hospital. Primary outcomes were spot urine iodine concentration (UIC), serum thyrotropin, and free thyroxine levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Twenty-seven patients were identified (74% male). The median age at screening was 48 months (range: 7\u2013213 months). The median duration on PN was 27 months (range: 11\u201377 months). Seventeen out of 20 patients (85%) were iodine deficient (spot UIC &amp;lt;100 \u03bcg\/L), whereas 11 out of 20 patients (55%) were severely iodine deficient (spot UIC &amp;lt;20 \u03bcg\/L). The prevalence of acquired hypothyroidism (elevated thyrotropin, low free thyroxine, and UIC &amp;lt;100 \u03bcg\/L) was 33% (n = 8). None of the children with hypothyroidism screened for autoimmune thyroiditis had positive test results. There was no statistically significant association between duration of PN use and development of iodine deficiency (P = .08) or hypothyroidism (P = .96).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Children on chronic PN are at risk for developing iodine deficiency and resultant hypothyroidism; hence, these children should be screened for these outcomes. Further studies are needed to define the temporal onset of iodine deficiency and timing to thyroid dysfunction related to PN.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2017-3046","type":"journal-article","created":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T08:25:14Z","timestamp":1519892714000},"source":"Crossref","is-referenced-by-count":21,"title":["Hypothyroidism and Iodine Deficiency in Children on Chronic Parenteral Nutrition"],"prefix":"10.1542","volume":"141","author":[{"given":"Chijioke","family":"Ikomi","sequence":"first","affiliation":[{"name":"Divisions of Endocrinology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conrad R.","family":"Cole","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology, and Nutrition, and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Vale","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology, and Nutrition, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjorie","family":"Golekoh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Children\u2019s Hospital of Michigan, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane C.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Divisions of Endocrinology,"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and"},{"name":"Biostatistics and Epidemiology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana-Hawa Yayah","family":"Jones","sequence":"additional","affiliation":[{"name":"Divisions of Endocrinology,"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2018,4,1]]},"reference":[{"issue":"3","key":"2021121022491589700_B1","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1152\/physrev.2001.81.3.1097","article-title":"Physiological and molecular basis of thyroid hormone action.","volume":"81","author":"Yen","year":"2001","journal-title":"Physiol Rev"},{"issue":"7","key":"2021121022491589700_B2","doi-asserted-by":"crossref","first-page":"3421","DOI":"10.1210\/jc.2003-032002","article-title":"Sources of dietary iodine: bread, cows\u2019 milk, and infant formula in the Boston area.","volume":"89","author":"Pearce","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"2021121022491589700_B3","volume-title":"Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide for Programme Managers","author":"World Health Organization","year":"2007","edition":"3rd ed."},{"issue":"1","key":"2021121022491589700_B4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.cgh.2005.10.002","article-title":"Short bowel syndrome and intestinal failure: consensus definitions and overview.","volume":"4","author":"O\u2019Keefe","year":"2006","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2021121022491589700_B5","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1002\/j.1536-4801.2005.tb00011.x","article-title":"1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), supported by the European Society of Paediatric Research (ESPR).","volume":"41","author":"Koletzko","year":"2005","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"4","key":"2021121022491589700_B6","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1177\/0884533612446706","article-title":"A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products [published correction appears in Nutr Clin Pract. 2014;29(5):701].","volume":"27","author":"Vanek","year":"2012","journal-title":"Nutr Clin Pract"},{"issue":"3","key":"2021121022491589700_B7","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.clnu.2009.02.005","article-title":"Requesting iodine supplementation in children on parenteral nutrition.","volume":"28","author":"Cicalese","year":"2009","journal-title":"Clin Nutr"},{"issue":"1","key":"2021121022491589700_B8","doi-asserted-by":"crossref","first-page":"F56","DOI":"10.1136\/fn.88.1.F56","article-title":"Iodine deficiency associated with parenteral nutrition in extreme preterm infants.","volume":"88","author":"Ibrahim","year":"2003","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"2","key":"2021121022491589700_B9","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0022-3476(05)81198-9","article-title":"Iodine supplementation in children receiving long-term parenteral nutrition.","volume":"121","author":"Moukarzel","year":"1992","journal-title":"J Pediatr"},{"issue":"2","key":"2021121022491589700_B10","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/0884533615611846","article-title":"Iodine supplementation for pediatric patients receiving long-term parenteral nutrition.","volume":"31","author":"Santoro","year":"2016","journal-title":"Nutr Clin Pract"},{"issue":"8","key":"2021121022491589700_B11","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1177\/0148607115584002","article-title":"Severe hypothyroidism from iodine deficiency associated with parenteral nutrition.","volume":"40","author":"Golekoh","year":"2016","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"5","key":"2021121022491589700_B12","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1177\/0148607114551799","article-title":"Iodine deficiency in a parenteral nutrition-dependent adolescent with intestinal pseudo-obstruction.","volume":"40","author":"Mortensen","year":"2016","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"7","key":"2021121022491589700_B13","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1177\/0148607113503370","article-title":"Hypothyroidism and iodine deficiency in an infant requiring total parenteral nutrition.","volume":"38","author":"Clarridge","year":"2014","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"2021121022491589700_B14","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1053\/j.gastro.2009.07.074","article-title":"Iodine: it\u2019s important in patients that require parenteral nutrition.","volume":"137","author":"Zimmermann","year":"2009","journal-title":"Gastroenterology"},{"issue":"4","key":"2021121022491589700_B15","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/S2213-8587(14)70225-6","article-title":"Iodine deficiency and thyroid disorders.","volume":"3","author":"Zimmermann","year":"2015","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"8","key":"2021121022491589700_B16","first-page":"3599","article-title":"Serum Tg\u2014a sensitive marker of thyroid abnormalities and iodine deficiency in epidemiological studies.","volume":"86","author":"Knudsen","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2021121022491589700_B17","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1089\/thy.2014.0052","article-title":"Thyroglobulin as a biomarker of iodine deficiency: a review.","volume":"24","author":"Ma","year":"2014","journal-title":"Thyroid"},{"issue":"2","key":"2021121022491589700_B18","first-page":"121","article-title":"Nutrition in the critically ill patient: part II. Parenteral nutrition.","volume":"5","author":"Atkinson","year":"2003","journal-title":"Crit Care Resusc"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-3046\/907573\/peds_20173046.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-3046\/907573\/peds_20173046.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T17:35:46Z","timestamp":1719855346000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/141\/4\/e20173046\/37713\/Hypothyroidism-and-Iodine-Deficiency-in-Children"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,1]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4,1]]},"published-print":{"date-parts":[[2018,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2017-3046","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,1]]},"article-number":"e20173046"}}