Transient lodine Organification Defect in Infants With Ectopic Thyroid Glands

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Abstract
Background: Thyroid gland ectopy is the most common cause in infants with congenital hypothyroidism (CH). Its association with iodine organification defect, as suggested by positive perchlorate discharge test (PDT) has been reported. However, whether such an association represents a true or transient defect has not yet been determined. This finding has an important clinical, epidemiological, and genetic implications. Objective: To determine the natural history of iodine organification defect in patients with CH caused by thyroid ectopy detected by neonatal screening. Design: Prospective longitudinal study. Setting: King Khalid University Hospital, Riyadh, Saudi Arabia. Patients and Methods: PDT was performed, at the time of diagnosis and follow-up, in infants who showed an enlarged ectopic thyroid gland with a Tc-99m pertechnetate uptake of 2% or more. Results: Of 115 neonates with ectopic thyroid glands, 19 showed an enlarged gland with Tc-99m uptake ranging from 2 to 3.2%. Perchlorate discharge test was performed in 13 of these and was consistent with iodine organification defect in nine. Repeated PDT in seven patients showed normal values. Conclusion: The results of the authors' study indicate the transient nature of the iodine organification defect and suggest that a delay in the developmental of synthetic mechanisms occur in the dysgenetic glands.