Introduction: There is no concensus whether euthyroid children with Hashimotos thyroiditis (HT) need treatment with thyroxine.
Aim of the study: To assess whether thyroxine influences goitre progression (calculated thyroid volume on U/S scan) in euthyroid children with HT.
Subjects and methods: We studied 50 euthyroid children with HT for a 2-year period. Children with a multinodular goitre were not included in the study. Twenty-five children (17 girls and 8 boys, median age (IQR) 12.1 (11.113.4) years) were randomised to receive thyroxine and 25 children (20 girls and 5 boys, age 12.2 years (11.113.0)) did not receive treatment and were followed-up. There were no significant differences in sex, age, height, height SDS, weight, weight SDS, BMI, BMI SDS, thyroid volume (7.7 (6.69.1) ml and 7.3 (6.2 8.4) ml, respectively and thyroid volume SD (1.1 (0.71.5) and 0.9 (0.41.4)) between the two groups.
Results: Following one year there was no significant difference in the thyroid volume (7.1 (5.810.2) and 9.0 (7.910.6) ml, respectively, P=0.128) and thyroid volume S.D. (1.0 (0.01.4) and 1.7 (0.82.0), P=0.075) between the treated and the non treated group. Three children of the non treated group who developed hypothyroidism and were treated were excluded from further analysis. Following 2 years, the children on thyroxine had significantly smaller thyroid volume (7.6 (6.39.2) vs 10.6 (8.212.1) ml, P=0.016) and thyroid volume S.D. (0.6 (0.31.0) vs 2.0 (1.12.3), P=0.001) compared to the children that did not receive treatment. When each group was studied separately and comparisons within groups were made, there was no significant difference in the thyroid volume nor in the thyroid volume S.D. before and after 1 year of treatment, however thyroid volume S.D. was significantly lower two years following treatment compared to the thyroid volume before treatment (P=0.002, Wilcoxon signed rank test). In the non treated group, thyroid volume and thyroid volume S.D. increased after the 1st year (P<0.0001 and P=0.007 respectively) and 2nd year (P=0.001 and P=0.016) of follow-up.
Conclusion: Treatment with thyroxine is beneficial for the further progression of goitre because it reduces thyroid volume significantly in euthyroid children with HT.