Kurtoğlu Selim, Akin Mustafa Ali, Daar Ghaniya, Akin Leyla, Memur Seyma, Korkmaz Levent, Baştuğ Osman, Yilmaz Selcan
Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey.
J Clin Res Pediatr Endocrinol. 2012 Jun;4(2):111-3. doi: 10.4274/jcrpe.553.
Radioactive iodine (RAI) is used effectively in the treatment of hyperthyroidism and thyroid cancer, but it is contraindicated during pregnancy. RAI treatment during pregnancy can lead to fetal hypothyroidism, mental retardation and increased malignancy risk in the infant. Pregnancy tests must be performed before treatment in all women of reproductive age. However, at times, RAI is being used before ruling out pregnancy. We herein present a male newborn infant with congenital hypothyroidism whose mother was given a three-week course of methimazole therapy for her multiple hyperactive nodules and subsequently received 20 mCi RAI during the 12th week of her pregnancy. The patient was referred to our neonatology unit at age two weeks when his thyrotropin (TSH) level was reported to be high in the neonatal screening test. Physical examination was normal. Laboratory investigations revealed hypothyroidism (free triiodothyronine 1.55 pg/mL, free thyroxine 2.9 pg/mL, TSH 452 mU/L, thyroglobulin 20.1 ng/mL). The thyroid gland could not be visualized by ultrasonography. L-thyroxine treatment was initiated.
放射性碘（RAI）在治疗甲状腺功能亢进和甲状腺癌方面有显著疗效，但在孕期是禁忌使用的。孕期进行RAI治疗可能导致胎儿甲状腺功能减退、智力发育迟缓，并增加婴儿患恶性肿瘤的风险。所有育龄女性在接受治疗前都必须进行妊娠检测。然而，有时在未排除妊娠的情况下就使用了RAI。在此，我们报告一例患有先天性甲状腺功能减退的男婴，其母亲因多发性高功能结节接受了为期三周的甲巯咪唑治疗，随后在怀孕第12周接受了20毫居里的RAI治疗。该患儿在出生两周时因新生儿筛查试验报告促甲状腺激素（TSH）水平升高被转诊至我们的新生儿科。体格检查正常。实验室检查显示甲状腺功能减退（游离三碘甲状腺原氨酸1.55皮克/毫升，游离甲状腺素2.9皮克/毫升，TSH 452毫国际单位/升，甲状腺球蛋白20.1纳克/毫升）。超声检查无法显示甲状腺。遂开始进行左甲状腺素治疗。
