Levothyroxine Treatment of Euthyroid Children with Autoimmune Hashimoto Thyroiditis: Results of a Multicenter,...

Area of Science:

• Pediatric Endocrinology
• Immunology
• Thyroidology

Background:

• Hashimoto thyroiditis (HT) in euthyroid children presents a treatment dilemma.
• The use of levothyroxine (L-T4) in these cases remains controversial.
• Understanding the impact of L-T4 on thyroid gland size is crucial.

Purpose of the Study:

• To investigate the effect of L-T4 treatment on thyroid gland volume in euthyroid children with HT.
• To assess the long-term impact of L-T4 on thyroid function and antibody levels.
• To determine if L-T4 treatment influences the progression of thyroid volume in pediatric HT.

Main Methods:

• A prospective, randomized, controlled trial was conducted.
• 59 euthyroid children with HT were enrolled; 25 received L-T4 and 34 were observed.
• Thyroid volume, TSH, free T4, and thyroid antibodies were monitored for 36 months via ultrasound and serum analysis.

Main Results:

• L-T4 treatment led to a statistically significant decrease in thyroid volume (SDS) compared to the observation group at 12 and 30 months.
• The mean thyroid volume (SDS) decreased by -1.01 in the treated group versus an increase of +0.27 in the observation group.
• Levothyroxine did not significantly alter thyroid function (TSH, free T4) or serum thyroid antibody levels.

Conclusions:

• Levothyroxine treatment can reduce thyroid gland volume in euthyroid children with Hashimoto thyroiditis.
• The observed reduction in thyroid volume is temporary and limited to a specific time frame.
• The findings suggest a nuanced role for L-T4 in managing pediatric HT, primarily concerning thyroid size rather than function.