ESPE2019 Poster Category 1 Thyroid (2) (13 abstracts)
Levothyroxine Effect on Thyroid Volume in Children with Autoimmune Hashimoto Thyroiditis (AHT) Presenting Subclinical (SH) or Overt (Oh) Hypothyroidism
Sofia Leka-Emiri 1 , Vassilios Petrou 1 , Cathrine Evangelopoulou 1 , Marina Vakaki 2 , Aspasia Fotinou 3 , Elpis Vlachopapadopoulou 1 & Stefanos Michalacos 1
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.
| 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-score | 0.55 (0.9) | 0.52 (1.0) | 0.43 (0.9) | |
| BMI z-score | 0.87 (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-score | 0.56 (1.0) | 0.59 0.9) | 0.43 (0.8 | |
| BMI z-score | 0.82(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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