Ultrasound scanning assessment of L-thyroxine treatment effectiveness in a group of children with diffuse goiter.
Ultrasound scanning is an accurate and objective method to assess thyroid volume; therefore it is useful to evaluate the effectiveness of L-thyroxine treatment in reducing goiter size, especially in children where clinical evaluation is inaccurate. In this prospectic study we evaluated the effectiveness of one-year L-thyroxine treatment in a group of children with nontoxic diffuse goiter coming from an area with low iodine intake. We examined 11 children (7 females, 4 males), age range 9-14 years. At clinical examination, 6 patients had a goiter classified Ia (according to WHO criteria), 4 had a class Ib and only 1 had a class II goiter. In order to achieve an accurate goiter evaluation, the thyroid volume was determined by ultrasonic scanning with a 5 MHz linear probe before and after treatment. Patients were given a dose of L-thyroxine (1.5-2.0 micrograms/kg/die) in order to significantly reduce serum TSH levels (from 1.8 +/- 0.6 to 0.8 +/- 0.5 mU/l, mean +/- SD). Patients were reexamined at 12 months of therapy and again at 10 months after therapy withdrawal. A significant reduction of the goiter volume (greater than 20%) was obtained in 6/11 (54%) patients, although serum TSH levels were fully suppressed only in one. The mean goiter size reduction in "responders" was -31.2 +/- 9.3% (m +/- SE). After therapy withdrawal goiter size increased in the majority of cases (in 4/11, greater than 20%). Our study demonstrates that L-thyroxine treatment is effective in reducing goiter size in the majority of children with a diffuse goiter.(ABSTRACT TRUNCATED AT 250 WORDS)
Regalbuto
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Cattedra di Endocrinologia, University of Catania, Ospedale Garibaldi, Italy.
Belfiore
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Giuffrida
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Ippolito
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Motta
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RM
Sava
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D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006042:Goiter / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013963:Thyroid Hormones / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use*; D014463:Ultrasonography
D013963:Thyroid Hormones; D013974:Thyroxine