HYPOTHYROIDISM SECONDARY TO TOPICAL IODINE TREATMENT IS INFANTS WITH SPINA-BIFIDA

Four infants with spina bifida, who had not undergone surgical closure of a lumbar myelomeningocele, were assessed and investigated for hypo thyroidism. From birth, all were treated once daily with an iodine-con taining ointment (Betadine) as a local antiseptic applied to the spina defect. All infants showed excess urinary iodine concentration. Two i nfants, without clinical evidence of hypothyroidism or goitre, showed low serum free thyroxine and high thyroid stimulating hormone concentr ations at a mean age of four weeks and were started on thyroxine repla cement treatment. Betadine ointment and thyroxine were stopped simulta neously at a mean age of nine months, following which all infants rema ined euthyroid. Thyroid function tests should be monitored routinely i f iodine is applied as a topical antiseptic to infants.