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Transient neonatal hypothyroidism after gestational exposure to amiodarone: A follow-up of two cases

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Abstract

Amiodarone (AMD) is an antiarrhythmic drug which contains 37% of iodine. It can reach the fetus by transplacental passage and induce fetal hypothyroidism. Since in some pregnant women AMD represents a cardinal therapeutic opportunity, it is necessary to establish not only the risk of teratogenicity linked to fetal AMD exposure but also to evaluate the psychomotor development of children with neonatal thyroid dysfunction related to fetal AMD exposure. We report on two cases involving children with an AMD gestational exposure and transient neonatal hypothyroidism, who were followed-up until the age of 4 years 8 months and 5 years 6 months, respectively. Denver’s developmental milestone test and Whechsler Preschool and Primary Scale of Intelligence (WPPSI) were administered to the patients in accordance to their age. A normal psychomotor development was observed in both patients with full scale IQ score, verbal and performance IQ scores within normal range. In conclusion, if these data were validated by larger studies, it might not be obligatory to discontinue AMD administration in cardiopathic pregnant women, since mental impairment may not necessarily occur in children with transient neonatal hypothyroidism caused by fetal AMD exposure. However, the evaluation of the thyroid function of these children is imperative.

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References

  1. Caron P. Effets de l’Amiodarone sur la fonction thyroïdienne. Presse Med. 24: 1747, 1995.

    CAS  PubMed  Google Scholar 

  2. Martino E., Aghini-Lombardi F., Mariotti S., Bartalena L., Braverman L.E., Pinchera A. Amiodarone: a common source of iodine-induced thyrotoxicosis. Horm. Res. 26: 158, 1987.

    Article  CAS  PubMed  Google Scholar 

  3. Trip M.D., Wiersinga W., Plomp T.A. Incidence, predictability, and pathogenesis of amiodarone-induced thyrotoxicosis and hypothyroidism. Am. J. Med. 91: 507, 1991.

    Article  CAS  PubMed  Google Scholar 

  4. Martino E., Aghini-Lombardi L., Bartalena L., Grasso L., Loviselli A., Velluzzi F., Pinchera A., Braverman L.E. Enhanced susceptibility to amiodarone-induced hypothyroidism in patients with thyroid autoimmune disease. Arch. Intern. Med. 154: 2722, 1994.

    Article  CAS  PubMed  Google Scholar 

  5. Rey E., Bachrach L.K., Burrow G.N. Effects of amiodarone during pregnancy. Can. Med. Assoc. J. 136: 959, 1987.

    CAS  Google Scholar 

  6. Plomp A.T., Vulsma T., Vijlder J.J.M. Use of amiodarone during pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 43: 201, 1992.

    Article  CAS  PubMed  Google Scholar 

  7. Freedman M.D., Somberg J.C. Pharmacology and pharmacokinetics of amiodarone. J. Clin. Pharmacol. 31: 1061, 1991.

    Article  CAS  PubMed  Google Scholar 

  8. Harjai K.J., Licata A.A. Effects of amiodarone on thyroid function. Ann. Intern. Med. 126: 63, 1997.

    Article  CAS  PubMed  Google Scholar 

  9. Vrobel T.R., Miller P.E., Mostow N.D., Rakita L. A general overview of amiodarone toxicity: its prevention, detection, and management. Prog. Cardiovasc. Dis. 31: 393, 1989.

    Article  CAS  PubMed  Google Scholar 

  10. Rovet J.F., Ehrlich R.M., Sorbara D.L. Neurodevelopment in infants and preschool children with congenital hypothyroidism: etiological and treatment factors affecting outcome. J. Pediatr. Psychol. 17: 187, 1992.

    Article  CAS  PubMed  Google Scholar 

  11. Rovet J.F., Ehrlich R.M., Sorbara D.L. Intellectual outcome in children with fetal hypothyroidism. J. Pediatr. 110: 700, 1987.

    Article  CAS  PubMed  Google Scholar 

  12. Matsumura L.K., Born D., Kunii I.S., Franco D.B., Maciel R.M.B. Outcome of thyroid function in newborns from mothers treated with amiodarone. Thyroid 2: 279, 1992

    Article  CAS  PubMed  Google Scholar 

  13. Flanagan R.J., Storey G.C.A., Holt D.W. Rapid high-performance liquid Chromatographic method for the measurement of amiodarone in blood plasma or serum at the concentrations attained during therapy. J. Chromatogr. 187: 391, 1980.

    Article  CAS  PubMed  Google Scholar 

  14. Frankerburg W.K., Dodds J.B. Denver Developmental Screening Test. J. Pediatr. 71: 181, 1967.

    Article  Google Scholar 

  15. Wechsler D. Wechsler Preschool and Primary Scale of Intelligence. Ed. Psychological Corporation, New York, 1967. (Italian edition, translated and adapted by permission in 1981 by S. Orsini, Organizzazioni Speciali, Firenze).

    Google Scholar 

  16. Decatte L., Dewolf D., Smitz J., Bougatef A., Deschepper J., Foulon W. Fetal hypothyroidism as a complication of amiodarone treatment for persistent fetal supraventricular tachycardia. Prenat. Diagn. 14: 762, 1994.

    Article  CAS  Google Scholar 

  17. Darwiche A., Vanlieferinghen P., Lemery D., Paire M., Lusson J.R. Amiodarone et tachicardie supraventriculaire foetal. A propos d’un cas avec hypothyroïdie néonatale. Arch. Fr. Pediatr. 49: 729, 1992.

    CAS  PubMed  Google Scholar 

  18. Ovadia M., Brito M., Hoyer G.L., Marcus F.I. Human experience with amiodarone in the embryonic period. Am. J. Cardiol. 73: 316, 1994.

    Article  CAS  PubMed  Google Scholar 

  19. Foster C.J. Amiodarone in pregnancy. Am. J. Cardiol. 74: 307, 1994.

    Article  CAS  PubMed  Google Scholar 

  20. Widerhorn J., Bhandari A.K., Bughi S., Rahimtoola S.H., Elkayam U. Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy. Am. Heart J. 1229: 1162, 1991.

    Article  Google Scholar 

  21. Magee L.A., Dawnar E., Sermer M., Boulton B.C., Allen L.C., Koren G. Pregnancy outcome after gestational exposure to amiodarone in Canada. Am. J. Obstet. Gynecol. 172: 1307, 1995.

    Article  CAS  PubMed  Google Scholar 

  22. Nademanee K., Piwonka R.W., Singh B.N., Hershman J.M. Amiodarone and thryoid function. Prog. Cardiovasc. Dis. 31: 427, 1989.

    Article  CAS  PubMed  Google Scholar 

  23. Gill J., Heel R.C., Fitton A. Amiodarone: an overview of its pharmacological properties, and review of its therapeutic use in cardiac arrhythmias. Drugs 43: 69, 1992.

    Article  CAS  PubMed  Google Scholar 

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Grosso, S., Berardi, R., Cioni, M. et al. Transient neonatal hypothyroidism after gestational exposure to amiodarone: A follow-up of two cases. J Endocrinol Invest 21, 699–702 (1998). https://doi.org/10.1007/BF03350801

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