Department of the Woman, The Child, of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy.
Front Endocrinol (Lausanne). 2022 Aug 11;13:927726. doi: 10.3389/fendo.2022.927726. eCollection 2022.
Soy-based infant formulas (SFs) are often consumed by cow's milk allergic children. However, some concerns have risen since soy intake may adversely affect thyroid function in iodine-deficient or subclinical hypothyroid individuals. We report the first Italian case of SF induced goiter and hypothyroidism registered in our country since National Iodine program has been instituted. Finally, we review cases previously reported in literature. A 22-month-old toddler with a previous diagnosis of cow's milk protein allergy came to clinical attention for important goiter and overt hypothyroidism. Detailed dietary anamnesis revealed that he was on a restrictive dietary regimen based on soymilk since 12 months of age. A temporary levothyroxine substitution was instituted to avoid hypothyroidism complications. Adequate iodine supplementation and diet diversification completely reversed SF-induced hypothyroidism and goiter, confirming the diagnostic suspicion of soymilk-induced thyroid dysfunction in a iodine-deficient toddler. This case report demonstrates the importance of careful dietary habits investigation and adequate micronutrients supplementation in children on a restrictive diet due to multiple food allergies in order to prevent nutritional deficits.
大豆配方食品（SFs）常被牛奶过敏的儿童食用。然而，由于大豆摄入可能会对碘缺乏或亚临床甲状腺功能减退个体的甲状腺功能产生不利影响，因此出现了一些担忧。我们报告了自国家碘计划实施以来，意大利首例因 SF 引起的甲状腺肿和甲状腺功能减退症的病例。最后，我们回顾了文献中以前报道过的病例。一个 22 个月大的幼儿，之前被诊断为牛奶蛋白过敏，因明显的甲状腺肿和明显的甲状腺功能减退而引起临床关注。详细的饮食病史显示，他从 12 个月大开始就采用基于豆浆的限制饮食方案。为了避免甲状腺功能减退症的并发症，暂时给予左甲状腺素替代治疗。适当的碘补充和饮食多样化完全逆转了 SF 引起的甲状腺功能减退症和甲状腺肿，证实了碘缺乏的幼儿因豆浆引起的甲状腺功能障碍的诊断怀疑。该病例报告表明，对于因多种食物过敏而采用限制饮食的儿童，仔细调查饮食习惯和适当补充微量营养素非常重要，以预防营养不足。
