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Thyroxine therapy results in a decrease in thyroid size in children and adolescents with chronic autoimmune thyroiditis
The
background of the study. Chronic autoimmune thyroiditis is characterized
by normal or decreased thyroid function and normal or increased thyroid
size. In this study, the effect of thyroxine (T4) therapy on both thyroid
function and volume was determined in children and adolescents with chronic
autoimmune thyroiditis.
How the study was done. There were 90 children and adolescents, 73 girls (mean age, 12 years) and 17 boys (mean age, 14 years) with chronic autoimmune thyroiditis, defined as a high serum antithyroid peroxidase or antithyroglobulin antibody concentration and thyroid hypoechogenicity, as determined by ultrasonography. Serum thyrotropin (TSH), total T4 or free T4, and thyroid volume (on ultrasonography) were measured before and during treatment with T4. The main outcome was the change in thyroid volume during treatment. The results were corrected for age and body-surface area and expressed as the standard deviation score (SDS). Goiter was defined as SDS >2.0.
The results of the study. Before treatment, 61 patients (68 percent) had a goiter, 35 (39 percent) were euthyroid, 42 (47 percent) had subclinical hypothyroidism, and 13 (14 percent) had overt hypothyroidism.
The average duration of treatment was 2.8 years, during which the median thyroid volume decreased significantly. The decrease in thyroid volume was correlated with the thyroid volume at base line, duration of treatment, and base-line serum TSH concentration. Among the patients with goiter, the decrease in thyroid volume was greater in those with hypothyroidism than in those who were euthyroid. Among the patients with no goiter, thyroid volume decreased in those who had hypothyroidism, but did not change in those who were euthyroid.
The conclusions of the study. T4 therapy results in a decrease in thyroid volume in children and adolescents with chronic autoimmune thyroiditis who have hypothyroidism, whether they have a goiter or not, whereas in those who are euthyroid, thyroid volume decreases only in those with goiter.
The original article. Svensson J, Ericsson UB, Nilsson P, Olsson C, Jonsson B, Lindberg B, Ivarsson SA. Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis. J Clin Endocrinol Metab 2006;91:1729-34.
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