Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism.
BACKGROUND
The question of whether children with subclinical hypothyroidism (SH) should be treated or not is controversial due to the lack of studies on outcomes of SH children treated with L-thyroxine (L-T(4)) versus those receiving no therapy.


OBJECTIVE
(a) To evaluate thyroid tests under L-T(4) and after therapy withdrawal in 69 SH children (group A) and (b) to compare our results with those recorded in 92 untreated children (group B).


METHODS
Group A children were treated for 24 months and TSH and FT(4) levels 3 months after therapy withdrawal were compared with those measured in group B at the end of follow-up in order to investigate treatment effects.


RESULTS
The prevalence of children who had normalized TSH at the end of follow-up was higher in group A, but the prevalence of those who had normalized or maintained unchanged TSH was similar in the two groups, as was the prevalence of children who exhibited a TSH increase >10 mU/l. In group A, TSH values at 27 months were associated with baseline values.


CONCLUSIONS
(a) Two-year treatment in SH children is unable to modify posttherapy outcome of hyperthyrotropinemia; (b) therapy is unable to prevent the risk of further TSH increase after treatment withdrawal, and (c) posttherapy TSH outcome is conditioned by baseline TSH.
Department of Pediatrics, University of Messina, Messina, Italy.
Malgorzata
M
Wasniewska
Andrea
A
Corrias
Tommaso
T
Aversa
Mariella
M
Valenzise
Alessandro
A
Mussa
Lucia
L
De Martino
Fortunato
F
Lombardo
Filippo
F
De Luca
Mariacarolina
M
Salerno
D000293:Adolescent; D058070:Asymptomatic Diseases / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D012720:Severity of Illness Index; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome
D013972:Thyrotropin; D013974:Thyroxine