About 3% of adult patients on a regimen of lithium carbonate develop a clinically visible goiter.1 Lithium reduces the conjugation of iodotyrosins as well as the secretion of thyroid hormones.2.3 Lithium crosses the placental barrier4 and might be teratogenic.5 We recently observed a prematurely born infant with large goiter whose mother had received lithium treatment throughout pregnancy.
Report of a Case.—A 32-year-old mother with endogenous depression had been treated throughout pregnancy with 750 mg of lithium carbonate daily. The baby was born after 37 weeks of gestation and weighed 2,100 gm. Within the first hours of life, the baby girl developed idiopathic respiratory distress syndrome and had to be intubated and given mechanical ventilatory assistance. Distended neck veins and an enlarged thyroid of soft consistency were noted (Figure).
A lateral roentgenogram of one leg showed normal ossification for gestational age. On the second day of
NARS PW, GIRARD J. Lithium Carbonate Intake During Pregnancy Leading to Large Goiter in a Premature Infant. Am J Dis Child. 1977;131(8):924-925. doi:10.1001/archpedi.1977.02120210102021