Congenital iodide-induced goitre with hypothyroidism.

Iodide-induced goitre with or without hypo- thyroidism is an unusual complication of prolonged iodide therapy.It has been reported both in children and adults (Bell, 1952; Morgans and Trotter, 1953; Turner and Howard, 1956; Skaggs and Cooke, 1956; Rubinstein and Oliner, 1957; Paley, Sobel, and Yalow, 1958; Paris et al., 1960; Falliers, 1960; Oppenheimer and McPherson, 1961).Congenital goitres have also been reported in the offspring of euthyroid mothers who received iodide therapy for asthma or other illnesses during their pregnancies (Parmelee et al., 1940; Bongio- vanni et al., 1956; Petty and DiBenedetto, 1957; Morgans and Trotter, 1959).Though thyroid function studies were not obtained on these re- ported cases, it is inferred that the babies were euthyroid.In 1962, Martin and Rento described the first two cases of iodide-induced goitre with hypothyroidism in newborn infants, and a similar case was reported by Croughs and Visser in 1965.We here report 3 additional cases of iodide- induced goitre with hypothyroidism in newboms, and comment on the pathogenesis of this type of thyroid dysfunction.Case Reports Case 1.A male infant was first seen aged 18 days, because of swelling in the neck, difficult breathing, and attacks of cyanosis dating from birth.Pregnancy and la- bour had been normal, but the mother, age 33 years, had been kept on oral tablets containing potassium iodide because of chronic asthma.She had taken 600 mg.potas- sium iodide daily during the previous 10 years.She had given birth to 7 other children, 4 of them before and 3 during iodide medication.All were living and well, with no history of thyroid enlargment at birth.The mother herself was clinically euthyroid and her thyroid gland was normal in size.On admission, the baby was mildly cyanotic, with marked inspiratory stridor on crying.The face was slightly puffy and the tongue enlarged and protruded.The skin was pale and mottled.There was conspicuous enlargement of the thyroid gland, which was moderately firm and smooth.Heart, chest, abdomen, and nervous system were clinically normal.