Levothyroxine treatment in pediatric benign thyroid nodules.
OBJECTIVE
To evaluate the effectiveness of levothyroxine therapy in benign thyroid nodules in pediatrics.


METHODS
Data from 78 euthyroid children and adolescents with benign thyroid nodules were retrospectively collected. Subjects were divided into 2 groups: levothyroxine treated (n = 36) and nontreated (n = 42), and the clinical, laboratory and sonographic features of the 2 groups were compared. Nodules were considered benign according to histology, fine-needle aspiration biopsy or by features suggestive for benignity. The groups were followed up for 2.4 ± 1.3 years, and treated patients received a mean dose of levothyroxine of 1.69 ± 0.66 μg/kg/day.


RESULTS
Patients in the treated and nontreated groups were comparable for age, sex and follow-up. A reduction in nodule diameter from 2.24 ± 0.94 to 1.86 ± 1.17 cm (p = 0.039) was observed in treated patients, whereas the nodule diameter increased from 1.66 ± 0.86 to 1.78 ± 0.91 cm in nontreated patients (p = 0.024). In the treatment group, 11 patients (30.6%) had a reduction greater than 50% and significantly decreased palpable nodules (p < 0.001). A nonsignificant reduction in reported symptoms was observed, too. The change in nodule size was directly correlated with thyroid-stimulating hormone levels (r = 0.640, p < 0.001) and inversely with levothyroxine dose (r = -0.389, p = 0.009). In nontreated subjects, both palpable nodules and symptoms increased.


CONCLUSIONS
This study supports levothyroxine treatment effectiveness in shrinking benign nodules.
Department of Pediatric Endocrinology and Diabetology, University of Turin, Turin, Italy. corrand@libero.it
Andrea
A
Corrias
Alessandro
A
Mussa
Malgorzata
M
Wasniewska
Maria
M
Segni
Alessandra
A
Cassio
Mariacarolina
M
Salerno
Roberto
R
Gastaldi
Maria Cristina
MC
Vigone
Milva
M
Bal
Patrizia
P
Matarazzo
Giovanna
G
Weber
Filippo
F
De Luca
D000293:Adolescent; D044963:Biopsy, Fine-Needle; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D016606:Thyroid Nodule / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use*; D047368:Tumor Burden / Q000187:drug effects; D018608:Ultrasonography, Doppler
D013972:Thyrotropin; D013974:Thyroxine