Detection of Iodine Deficiency Disorders (Goiter and Hypothyroidism) in School-Children Living in Endemic Mountainous Regions, After the Implementation of Universal Salt Iodization

Kun, Imre Zoltan; Szántó, Zoltán; Balázs, Judit; Nasalean, Anisie; Gliga, Camelia

doi:10.5772/54188

Cited by 5 publications

(7 citation statements)

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“…Given the increased risk for the development of AIT in endemic iodine-defi cient areas and the persistence of a mild defi ciency iodate endemic in Romania [26][27][28], we recommend to perform a thyroid ultrasound to identify patients with thyroid nodular goiter who are at risk for developing thyroid dysfunctions, especially if they come from areas with deficient iodine intake.…”

Section: Resultsmentioning

confidence: 99%

The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

Ancuța-Elena

Capraru

Ionela

2013

Acta Medica Marisiensis

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Introduction: Amiodarone (AMI), a class III anti-arrhythmic drug, is associated with a number of side effects, including thyroid dysfunction (both hypo-and hyperthyroidism), which is due to amiodarone's high iodine content and its direct toxic effect on the thyroid. Objective: To evaluate the incidence of Amiodarone induced thyrotoxicosis (AIT) (type, rate of occurrence) and to identify the risk factors involved in its occurrence. Material and method:We examined patients treated with amiodarone, between January 2002 and December 2011, who presented to our Department of Endocrinology Târgu Mures for thyroid dysfunctions. Results: The retrospective study included 87 patients with thyroid dysfunctions; 58 (66.7%) patients had AIT and 29 (33.3%) had Amiodarone induced hypothyroidism (AIH). In the AIT group: 35 were women (60.3%), 23 were men (39.7%); the average age was 61.60 ± 12.39 years. Risk factors identifi ed for the AIT group were male gender (RR = OR = 3.8; Chi-squer = 5.7, p = 0.004) and pre-existing thyroid abnormalities (RR = 2.5, Chi-square = 4.1, p = 0.005). The thyroid dysfunction occurrence was heterogeneous (0.2-183 months). The patients with previous thyroid abnormalities developed earlier thyroid dysfunction compared to those with an apparently normal thyroid gland (22.25 ± 4.14 months versus 32.09 ± 7.69 months, p = 0.02, T test). Conclusion: In the context of the specifi c iodine geoclimatic intake and the area of origin, amiodarone -induced thyroid dysfunction spectrum is dominated by thyrotoxicosis. Screening and monitoring of thyroid function for patiens under chronic amiodarone treatment is necessary.

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Section: Resultsmentioning

confidence: 99%

The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

Ancuța-Elena

Capraru

Ionela

2013

Acta Medica Marisiensis

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“…Kun у 2013 році. Установлено, що показники йодурії були нижчими від нормальних у 68 % обстежених учнів, із яких приблизно 40 % мали тяжкий дефіцит йоду [18]. В іншому дослідженні [19] проаналізовано концентрацію йодурії в дітей із затримкою росту у двох регіонах Румунії (гірському та рівнинному).…”

Section: обговоренняunclassified

Состояние Йодного Обеспечения Детей Препубертатного Возраста, Проживающих На Территории Северной Буковины

Sorokman¹,

Bachu²,

Gingulyak³

2021

Mìžnarodnij endokrinologìčnij žurnal

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Background. In Bukovina, depending on climatic and geographical zones, there is a mild and moderate degree of iodine deficiency. Assessment of urinary inorganic iodine excretion allows monitoring of the epidemiological situation regarding the severity of iodine deficiency in the region. The purpose was to assess the indicators of ioduria in prepubertal children living in the Northern Bukovina (Chernivtsi region). Materials and methods. As part of a 20-cluster analysis of the prevalence of goiter among the pediatric population of Chernivtsi region, 1,973 children aged 7 to 12 years were examined and the concentration of inorganic iodine in a single portion of urine was determined in 197 children. The obtained results were processed by the method of statistical variation and correlation analysis. Results. Manual palpation examination showed a significant incidence of goiter among children in Bukovina — 17.6 %. Thyromegaly among children of the reference group occurred in 15.1 % of cases. The median ioduria in the examined population is generally 60.4 μg/l. The average prevalence of iodine deficiency was 59.70 ± 1.82 %, the incidence of severe iodine deficiency did not exceed 5.22 ± 1.30 %. Analyzing the degree of iodine supply of children depending on the geographical areas of residence, we conclude that children living in the plains and children from Chernivtsi have mild iodine deficiency (median ioduria is 72.2 and 70.4 μg/l, respectively), and children from mountainous areas — moderate iodine deficiency (median ioduria is 42.9 μg/l). The average prevalence of iodine deficiency was 59.70 ± 1.82 %, and excessive iodine in the urine — 18.70 ± 2.49 %. Moreover, the incidence of severe iodine deficiency did not exceed 5.22 ± 1.30 %. Conclusions. In most children living in Northern Bukovina, the median ioduria is reduced. In 18.7 % of children, the iodine content is more than 300 μg/l, which requires further monitoring.

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“…During its liver metabolization, approximately 6 mg of inorganic iodine per 200 mg of amiodarone ingested is released into the systemic circulation [45]. The average iodine content in Romanian diet is approximately 50-75 μg/day [3,46,47]. Thus, 6 mg of iodine markedly increases the daily iodine load.…”

Section: Amiodarone Pharmacologymentioning

confidence: 99%

“…This is thought to be primarily due to differences in dietary iodine intake. In iodinedeficient regions, as some geographical zones were in Romania before universal salt iodization [3], AIT occurs in approximately 10-12% of patients with type 1 AIT usually predominating [64,67]. However, the distribution of cases by type may be changing, as illustrated in a report of 215 consecutive patients with AIT seen at a single institution in Italy over 26 years [71].…”

Section: Clinical Forms Of Amiodarone-induced Hyperthyroidismmentioning

confidence: 99%

“…The worldwide variability of the dietary intake of iodine depends on the iodine content of the soil, water, and the dietary practice. After Iodine Global Network data [2], the iodine uptake in Romania in 2004 was considered adequate, the median urinary iodine content (MUIC, normal value ≥100 μg/L) being 102 μg/L in school-aged children, but in some geographic regions, such as mountainous villages of Mureș County, a mild iodine deficiency was detected [3]. The MUIC value (68 μg/L) in pregnant women confirmed that iodine intake in this population of Romania is insufficient [2].…”

Section: Introductionmentioning

confidence: 99%

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Prevention and Treatment of Iodine-Induced Thyrotoxicosis

Kolcsár¹,

Gáll²

2020

Goiter - Causes and Treatment

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Etiologies of thyrotoxicosis are diverse, one of them being caused by iodineinduced hyperthyroidism. The clinical signs of the disease are the classical signs of any form of hyperthyroidism, but the treatment of the different forms presents particular aspects. This chapter reviews the risk factors for thyrotoxicosis following an excess iodine load, pointing out the major sources of iodine: supplementation programs, dietary intake, nutritional supplements, iodine-containing contrast medium, and amiodarone. Prevention of iodine-induced thyrotoxicosis is critical in geriatric patients who often have thyroid nodular disease, underlying heart conditions, and therefore, hyperthyroidism may be more difficult to detect clinically. Treatment of iodine-induced thyrotoxicosis could be performed with thioamides or perchlorate prior to the administration of an iodine containing product (e.g., food, dietary supplements, and contrast media). On the other hand, amiodarone-induced thyrotoxicosis needs further attention and a close collaboration between cardiology and endocrinology to overcome complications, but individualization of the therapy should be undertaken. Based on the specific features of amiodarone-induced thyrotoxicosis thioamides, perchlorate, high-dose glucocorticoids, or radioiodine therapy may be considered for an optimal therapeutic intervention.

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Detection of Iodine Deficiency Disorders (Goiter and Hypothyroidism) in School-Children Living in Endemic Mountainous Regions, After the Implementation of Universal Salt Iodization

Cited by 5 publications

References 30 publications

The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

Состояние Йодного Обеспечения Детей Препубертатного Возраста, Проживающих На Территории Северной Буковины

Prevention and Treatment of Iodine-Induced Thyrotoxicosis

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