The role of 123I imaging in the evaluation of infants with mild congenital hypothyroidism

Evan Graber, Molly O. Regelmann, Rachel Annunziato, Josef Machac, Robert Rapaport

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background/Aims: Controversy exists regarding the diagnosis and treatment of mild congenital hypothyroidism (MCH). We studied the value of 123I imaging in patients with MCH. Methods: Retrospective chart review of infants and children <4 years of age who underwent 123I imaging: group 1 = MCH [thyroid-stimulating hormone (TSH) <25 μIU/ml, normal free T4/T3], group 2 = severe congenital hypothyroidism (TSH ≥25 μIU/ml), and group 3 = MCH in infancy imaged after treatment withdrawal at age 3 years. Data collected included 4- and 24-hour 123I uptake, TSH, free T4/total T3 at imaging, age at imaging, and levothyroxine (L-T4) dose at 1 year of. Results: Thirty-six patients underwent 123I imaging. In group 1 (n = 20, median TSH: 8.49 μIU/ml), 85% had abnormal imaging consistent with dyshormonogenesis. Two patients were referred after 1 year of age. The median age at imaging for the remaining 18 patients was 54 days. Median L-T4 dose at 1 year of age for these 18 patients was 2.8 μg/kg, which is consistent with dyshormonogenesis. Ninety-one percent of group 2 (n = 11, median TSH: 428.03 μIU/ml) had abnormal imaging. The median age at imaging was 13 days. Four patients in group 3 had abnormal 123I imaging and restarted treatment. Conclusion:123I imaging is a valuable tool for evaluation, diagnosis, and treatment of MCH.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalHormone Research in Paediatrics
Issue number2
StatePublished - 24 Mar 2015


  • Congenital hypothyroidism
  • Dyshormonogenesis
  • Iodine
  • Mild congenital hypothyroidism
  • Thyroid imaging


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