ESPE Abstracts (2019) 92 P1-432

Levothyroxine Effect on Thyroid Volume in Children with Autoimmune Hashimoto Thyroiditis (AHT) Presenting Subclinical (SH) or Overt (Oh) Hypothyroidism

Sofia Leka-Emiri1, Vassilios Petrou1, Cathrine Evangelopoulou1, Marina Vakaki2, Aspasia Fotinou3, Elpis Vlachopapadopoulou1, Stefanos Michalacos1


1Department of Endocrinology-Growth and Developent, "P&A KYRIAKOU" Children's Hospital, Athens, Greece. 2Department of Radiology,"P&A KYRIAKOU" Children's Hospital, Athens, Greece. 3Department of Biochemistry-Hormonology, "P&A KYRIAKOU" Children's Hospital, Athens, Greece


Objectives: Assess thyroid volume in relation to TSH and FT4 at diagnosis of AHT and 2.9 years of follow up in children with SH or OH.

Methods: wo hundred one children (155 girls) with AHT were divided according to TSH and FT4 levels [SH-FT4 >1.0 ng/dl: Group 1: TSH: 5-7.5 mU/l, Group 2: TSH: >7.5 mU/l, OH: Group 3: TSH>7.5 mU/l and FT4 ≤1.0ng/dl]. Mean L-T4 dose is reported in µg/Kg/day. Thyroid volume was calculated by the modified formula of the rotation ellipsoid: Vol (mL)= 0.479 (depth x width x length). TV was defined as the sum of the volumes of both lobes (isthmus not included).

Results: Main characteristics are shown in table 1. At diagnosis, TSH, FT4 levels, L-T4 dose and thyroid volume were significantly different (P<0.05) between SH (groups 1 and 2) as compared to OH (group 3). At follow-up all patients were euthyroid and TSH and FT4 levels did not differ significantly between groups. L-T4 dose was significantly higher in OH as compared to group 1 but not group 2. Thyroid volume did not differ significantly among groups.

Table 1. Data are shown as means (SD).
Group 1
(n=70)
Group 2
(n=72)
Group 3
(n=59)
*p
AT DIAGNOSIS
Age (yrs)10.4 (2.6)8.9 (2.6)9.6 (2.4)
Height z-score0.55 (0.9)0.52 (1.0)0.43 (0.9)
BMI z-score0.87 (0.9)0.93 (0.9)0.92 (1.1)
TSH (mU/l)6.1 (0.7)10.9 (5.6)47.9 (74.2)*
FT4 (ng/dl)1.2 (0.2)1.3 (0.16)0.85 (0.1)*
L-T4 (µg/Kg/day)1.1 (0.39)1.3 (0.51)1.5 (0.6)*
Thyroid volume (ml)8.0 (4.3)6.3 (3.7)10.1 (6.3)*
AT FOLLOW UP (yrs)2.8 (1.4) 3.16 (1.6)2.98 (1.6)
Age (yrs)13.2 (2.4)12.1 (2.7)12.6 (2.4)
Height z-score0.56 (1.0)0.59 0.9)0.43 (0.8
BMI z-score0.82(0.8)0.76 (0.9)0.92 (0.9)
TSH (mU/l)2.2 (1.2)2.6 (1.2)2.2 (1.1)
FT4 (ng/dl)1.4 (0.2)1.4 (0.4)1.3 (0.2)
L-T4 (µg/Kg/day)1.1 (0.3)1.4 (0.4)1.6 (0.7)*
Thyroid volume (ml)7.7 (4.1)6.7 (3.9)8.4 (3.5)
*One-Way Analysis of variance (ANOVA), P<0.05.

Conclusions: At diagnosis, L-T4 needs and thyroid volume are significantly lower in SH patients as opposed to OH patients. At 2.9 yrs, children with OH receive significantly higher LT-4 doses than those with SH and TSH < 7.5 mU/l but similar with those of SH and TSH > 7.5 mU/l and all present similar thyroid volumes.

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