Primary thyroid dysfunction after single intravenous iodinated contrast exposure in young children: a propensity score m
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ORIGINAL ARTICLE
Primary thyroid dysfunction after single intravenous iodinated contrast exposure in young children: a propensity score matched analysis Leah A. Gilligan 1,2 & Jonathan R. Dillman 1,3 & Weizhe Su 4 & Bin Zhang 4,5 & Janet Chuang 5,6 & Andrew T. Trout 1,3,5 Received: 10 June 2020 / Revised: 1 September 2020 / Accepted: 8 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Data suggest an increased risk of thyroid dysfunction following iodine-based contrast material (IBCM) in children. Objective To estimate the prevalence of thyroid stimulating hormone (TSH) abnormalities following exposure to a single dose of intravenous IBCM during computed tomography (CT) in young children. Materials and methods Inpatients ≤24 months of age who underwent a single CT with intravenous IBCM (exposed cohort) or abdominal ultrasound (US) (unexposed cohort) examination and had a TSH value obtained within 90 days after imaging between January 2009 to November 2018 were identified. Propensity score matching with 20 variables was performed. Primary thyroid dysfunction was defined by abnormally high or low TSH value. Multivariable logistic regression identified risk factors, including intravenous IBCM, for thyroid dysfunction. Results From the eligible 4,215 imaging examinations, 114 unique patients were included in the propensity matched population (n=57 per group). Thyroid dysfunction was identified in 14% (8/57) and 7% (4/57) of the IBCM-exposed and IBCM-unexposed cohorts, respectively. No patient in either cohort was started on thyroid hormone supplementation within the 3 months after imaging. Intravenous IBCM exposure was not a significant predictor of thyroid dysfunction on univariable (odds ratio [OR]=2.16, 95% confidence interval [CI]=0.61–7.64, P=0.23) or multivariable (OR=2.61, 95% CI=0.65–10.55, P=0.18) analyses. Significant independent predictors of post-imaging thyroid dysfunction included height (OR=1.25, P=0.0095) and trisomy 21 (OR=4.04, P=0.019). Conclusion Hospitalized children ≤24 months of age who received a single dose of intravenous IBCM for CT examination had a similar prevalence of TSH abnormalities compared to a propensity score matched group who underwent abdominal US. One dose of intravenous IBCM likely does not cause prolonged TSH abnormalities; however, larger studies are needed. Keywords Children . Computed tomography . Hyperthyroidism . Hypothyroidism . Iodine-based contrast material . Pediatric . Propensity score matching . Thyroid stimulating hormone
* Andrew T. Trout [email protected]
4
Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH 45229, USA
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Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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3
Department of Radio
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