Swedish scientists have found that levothyroxine treatment effectively reduces thyroid volume, particularly in hypothyroid, but also in euthyroid children with goiter caused by autoimmune thyroiditis (AIT).
Based on these findings, the research team recommends the use of levothyroxine therapy for the treatment of goiter in both euthyroid and hypothyroid children with AIT.
Reporting in the Journal of Clinical Endocrinology & Metabolism, the team says that although the beneficial effects of levothyroxine treatment in reducing thyroid volume for adults are well established, the treatment effect is less clear for children and adolescents.
Moreover, on this topic, "only a few studies have been performed, and none of these have used ultrasonography to evaluate changes in thyroid size," they add.
To address this imbalance, Johan Svensson, from Malmö University Hospital, and co-workers used thyroid ultrasonography to evaluate the effect of levothyroxine treatment on changes in thyroid volume SD score (SDS) in 90 children with AIT.
The participants' ages ranged from 6.1 to 17.7 years, and there were 73 girls. Each volunteer received treatment with levothyroxine for a median of 2.8 years. They were considered to be goitrous at baseline if they had an SDS value greater than 2.0.
Ultrasonography showed that at the time of AIT diagnosis, median thyroid volume SDS was significantly reduced in all children, whether they were euthyroid, subclinically hypothyroid, or overtly hypothyroid, with values declining by 0.4, 1.4, and 1.8, respectively.
Furthermore, children with goiter who were both hypothyroid and euthyroid showed a significant reduction in median thyroid volume SDS over the course of their levothyroxine therapy, with values decreasing by 1.6 and 0.9, respectively.
Children who lacked goiter but were hypothyroid also showed a 1.2 SDS reduction in median SDS because of treatment, but euthyroid children with goiter did not.
"Using an objective method for estimation of thyroid volume and a reference enabling assessment of a subjects' expected thyroid volume growth during the study period, we found levothyroxine treatment efficient in reducing thyroid volume SDS," Svensson et al summarize.
"Whether levothyroxine therapy can prevent development of goiter in euthyroid children without goiter is a subject for future investigation," they propose.