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Treatment of neonatal hyperthyroidism due to Graves' disease with sodium ipodate.

Abstract
We describe the effect of administration of repeated doses of sodium ipodate in a newborn infant with hyperthyroidism due to transient Graves' disease. Pretreatment (day 3) serum T4 and T3 concentrations were 49 micrograms/dl and 590 ng/dl, respectively. With 24 h after the first dose of ipodate, serum T3 fell by 40%, and it subsequently ranged from 209-278 ng/dl throughout the 39-day ipodate treatment period. Serum T4 also decreased after ipodate administration to 69% and 41% of the pretreatment value after 72 h and 7 days of treatment, respectively; values thereafter during treatment ranged from 19-22 micrograms/dl. These plateau values are in the upper range of normal for the neonatal period. Rapid clinical improvement occurred as the hyperiodothyroninemia abated. Serum rT3 concentrations increased from 468-672 ng/dl to greater than 1400 ng/dl 24 h after each ipodate dose. Thyroid-stimulating immunoglobulin was present in maternal and cord sera, and the half-life of serum thyroid-stimulating immunoglobulin in the infant was approximately 12 days. Antithyroglobulin and antimicrosomal antibodies were present in the infant at 10 days of age, and the titers decreased progressively thereafter; the half-life for the antimicrosomal antibody titer was 3 weeks. The data suggest that sodium ipodate can be useful for treatment of neonatal hyperthyroidism due to Graves' disease.
AuthorsB A Karpman, B Rapoport, S Filetti, D A Fisher
JournalThe Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 64 Issue 1 Pg. 119-23 (Jan 1987) ISSN: 0021-972X [Print] United States
PMID3782427 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Antibodies
  • Triiodothyronine
  • Triiodothyronine, Reverse
  • Thyrotropin
  • Ipodate
  • Thyroxine
Topics
  • Antibodies (analysis)
  • Female
  • Graves Disease (complications)
  • Humans
  • Hyperthyroidism (blood, drug therapy, etiology)
  • Infant, Newborn
  • Ipodate (therapeutic use)
  • Thyroid Gland (immunology)
  • Thyrotropin (blood)
  • Thyroxine (blood)
  • Triiodothyronine (blood)
  • Triiodothyronine, Reverse (blood)

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