Investigating thyroid dysfunction in pediatric patients following the administration of iodinated contrast media during cardiac catheterization.

OBJECTIVES

To determine the incidence and severity of thyroid dysfunction following iodinated contrast media (ICM) exposure in our pediatric heart center, assess adherence to FDA guidelines and evaluate the utility of routine thyroid function testing.

METHODS

This retrospective study reviewed charts of 186 patients under four years old who underwent cardiac catheterization between June 2022 and June 2024 at our pediatric heart center. Data collected included age, sex, gestational age, ethnicity, ICM use, and post-procedure thyroid-stimulating hormone (TSH) levels. Additional risk factors were assessed for patients with abnormal thyroid studies.

RESULTS

Of the 186 cardiac catheterization procedures, 155 involved administration of ICM. Follow-up thyroid studies were conducted after 113 of these; three lab draws were excluded due to new diagnoses of hypothyroidism made during the study period. Among the remaining 110 cases with indicated TSH testing, only two patients (1.8 %) demonstrated persistently elevated TSH levels - both of whom had pre-existing risk factors for thyroid dysfunction. Among the 113 cases that completed follow-up TSH studies, 69 (61.1 %) occurred within the FDA's recommended 3-week period. Post-procedure thyroid studies were not completed in 42 cases (27.1 %), although four patients had passed away and four were transferred to another hospital system.

CONCLUSIONS

No clinically significant relationship was found between ICM exposure and thyroid dysfunction in patients under four years old, suggesting routine post-catheterization thyroid screening may be unnecessary.