[Therapy of juvenile struma. Comparison between combination treatment and monotherapy]

91 children (70 girls and 21 boys) aged between 5 and 16 years were treated orally with thyroid hormones for euthyroid juvenile goiter. Maximally for 54 months. 16.5% of the children had a goiter size I, 69.2% size II, and 14.3% size III. 59 patients were treated for an average of 15.3 months with a mean daily dose of 90.9 micrograms thyroxine (T4) plus 18.2 micrograms triiodothyronine (T3) per m2 body surface. 32 patients received T4 in a mean daily dose of 88 micrograms/m2 body surface for an average of 7.5 months. The patients were examined 3-monthly in the outpatient department. The correlations between doses of thyroid hormones and serum concentrations of PBI or T4 were evaluated retrospectively using treatment records. The correlations were significant with r = 0.310 (T4 + T3) and r = 0.138 (T4). The large spread of PBI or T4 concentrations proved that compliance and enteral resorption influence the efficacy of treatment with thyroid hormones. Despite the different length of therapy 73% of patients on combined therapy and 72% of patients on thyroxine alone achieved a reduction of the size of their goiter. In both treatment groups the results of therapy were best (70% improvement) when the T4-concentrations ranged between 9.4 and 10.7 micrograms/dl. The number of complaints per patients during therapy was independent of the hormone dosages. During the first seven follow-up examinations patients on the combined hormone schedule uttered an average of 2.5 complaints, while the patients on thyroxine alone had an average of 1.1 complaints.