title: Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis.
abstract: BACKGROUND
  The use of levothyroxine to reduce thyroid size in pediatric patients with goiter due to chronic autoimmune thyroiditis (AIT) remains controversial. In overtly hypothyroid patients, reductions in thyroid volume have been reported, whereas the effect in subclinically hypothyroid and euthyroid patients is less clear.
  
  
  OBJECTIVE
  The objective of the study was to evaluate the effect of levothyroxine treatment on thyroid size (determined with thyroid ultrasonography) in children and adolescents with AIT.
  
  
  METHODS
  This study included patients with AIT treated at a university hospital outpatient clinic between 1987 and 2004.
  
  
  METHODS
  Ninety children with AIT (73 girls and 17 boys, aged 6.1-17.7 yr) were included in the study.
  
  
  METHODS
  Intervention was treatment with levothyroxine for a median 2.8 yr (range 0.5-10.2).
  
  
  METHODS
  Change in thyroid volume sd score (SDS) during the study period was measured.
  
  
  RESULTS
  Median thyroid volume SDS was reduced in patients euthyroid (-0.4 SDS, P < 0.001), subclinically hypothyroid (-1.4 SDS, P < 0.001), and overtly hypothyroid (-1.8 SDS, P < 0.002) at diagnosis of AIT. Both hypothyroid and euthyroid patients with goiter (thyroid volume > 2.0 SDS) at baseline reduced their median thyroid volume SDS (-1.6 and -0.9, respectively, P < 0.001). Hypothyroid patients without goiter also reduced median thyroid volume SDS (-1.2, P < 0.004), whereas no change was noticed in euthyroid children without goiter.
  
  
  CONCLUSIONS
  Levothyroxine treatment is effective in reducing thyroid volume in pediatric patients and is suggested in treatment of goiter caused by AIT, especially in cases of hypothyroid, but also in euthyroid children.
authors.affiliation: Department of Pediatrics, Malmö University Hospital, Lund University, SE-205 02 Malmö, Sweden. johan.svensson@med.lu.se
authors.forename: Johan
authors.initials: J
authors.lastname: Svensson
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Ericsson
authors.forename: Paul
authors.initials: P
authors.lastname: Nilsson
authors.forename: Catherine
authors.initials: C
authors.lastname: Olsson
authors.forename: Björn
authors.initials: B
authors.lastname: Jonsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindberg
authors.forename: Sten-A
authors.initials: SA
authors.lastname: Ivarsson
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D006042:Goiter / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D014284:Triiodothyronine / Q000097:blood; D014463:Ultrasonography
chemical_list: D014284:Triiodothyronine; D013972:Thyrotropin; D007453:Iodide Peroxidase; D013974:Thyroxine