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Treatment of Neonatal Hyperthyroidism due to Graves’ Disease with Sodium Ipodate^*

Departments of Pediatrics and Medicine, UCLA School of Medicine and Harbor-UCLA Medical Center Torrance, California 90509
Medical Service, Veterans Administration Hospital San Francisco, California 94904

Address requests for reprints to: Delbert A. Fisher, M.D., Harbor-UCLA Medical Center, A-17 Annex, 1000 West Carson Street, Torrance, California 90509.

We describe the effect of administration of repeated doses of sodium ipodate in a newborn infant with hyper-thyroidism due to transient Graves’ disease. Pretreatment (day 3) serum T₄ and T₃ concentrations were 49 µg/dl and 590 ng/dl, respectively. With 24 h after the first dose of ipodate, serum T₃ fell by 40%, and it subsequently ranged from 209–278 ng/dl throughout the 39-day ipodate treatment period. Serum T₄ also decreased after ipodate administration to 69% and 41% of the pretreatment value after 72 h and 7 days of treatment, respectively; values thereafter during treatment ranged from 19–22 µg/dl. These plateau values are in the upper range of normal for the neonatal period. Rapid clinical improvement occurred as the hyperiodothyroninemia abated. Serum rT₃ concentrations increased from 468–672 ng/dl to greater than 1400 ng/dl 24 h after each ipodate dose. Thyroid-stimulating immunoglobulin was present in maternal and cord sera, and the half-life of serum thyroid-stimulating immunoglobulin in the infant was approximately 12 days. Antithyroglobulin and antimicrosomal antibodies were present in the infant at 10 days of age, and the titers decreased progressively thereafter; the half-life for the antimicrosomal antibody titer was 3 weeks. The data suggest that sodium ipodate can be useful for treatment of neonatal hyper-thyroidism due to Graves’s disease.

^* This work was supported in part by PHS Grant HD-04270 from the NICHHD.

Received July 22, 1986.

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