Endocrine Abstracts (2008) 16 P703

Results of thyroxine therapy on thyroid nodules size in children with Hashimoto's thyroiditis

Vassiliki Skarpa, Athanasia Tertipi, Vassilios Petrou, Eleni Kostakioti, Elvira Posaghidou, Eleni Kousta, Petros Papachilleos, Aphroditi Kitsopoulou, Marina Vakaki, Aspasia Fotinou, Dimitris Ioanidis, Asteroula Papathanasiou & Charalambos Hadjiathanasiou

Department of Endocrinology, Children’s Hospital ‘P.and A. Kyriakou’, Athens, Greece.

Aim: To study the effect of thyroxine treatment on the size of thyroid nodules in children with Hashimoto’s thyroiditis

Patients and methods: Twenty-two girls and 6 boys (78.6/21.4%) were followed for 2 years under thyroxine therapy, at mean dose 1.6±0.4 μg/kg per day. Diagnosis of Hashimoto’s thyroiditis was based on the high value of either antithyroid antibodies, ATPO or ATG. Age at presentation was 10.6±2.0 year (6.2–13.6). Nineteen patients were pubertal and 9 prepubertal (67.9/32.1%). Thirteen (46.4%) were euthyroid, 12 (42.9%) with subclinical hypothyroidism and 3 (10.7%) hypothyroid. The size of thyroid nodules was 0.97±0.38 cm (0.6–2.2). All nodules ≥1 cm were examined by FNA that confirmed Hashimoto’s thyroiditis. For the statistical analysis, t-test and Mann–Whitney test were used.

Results: At presentation, there was not any significant difference in nodule size between euthyroid children and children with hypothyroidism or subclinical hypothyroidism, 0.9±0.2 vs 1.0±0.4 cm, respectivelly, P>0.05. Nodule’s size ≥1 cm had 42.9% of children (N=12). Decrease in nodule size ≥0.3 cm after 2 years with thyroxine was observed in 75.0% (N=21). Overall, nodule size showed significant decrease, from 0.97±0.38 cm at start of thyroxine to 0.64±0.48 cm, P<0.001, after 1 year and to 0.65±0.47 cm, P<0.001, after 2 years of treatment. Separately, in euthyroid children nodule size decreased from 0.96±0.30 cm at start of thyroxine, to 0.58±0.48 cm, P=0.027, after 1 year and to 0.63±0.46 cm, P=0.045, after 2 years under treatment. In children with hypothyroidism or subclinical hypothyroidism, nodule size decreased from 1.00±0.43 to 0.69±0.49 cm, P=0.024, after 1 year and to 0.68±0.49 cm, P=0.007, after 2 years under treatment.

Conclusions: Treatment with thyroxine in children with thyroid nodules due to Hashimoto’s thyroiditis can significantly decrease the size of the nodules, in children with euthyroidism and in those with hypothyroidism or subclinical hypothyroidism, as well.