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Early treatment with l ‐thyroxine in children and adolescents with type 1 diabetes, positive thyroid antibodies, and thyroid gland enlargement
Author(s) -
Kordonouri Olga,
Hartmann Reinhard,
Riebel Thomas,
Liesenkoetter KlausPeter
Publication year - 2007
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2007.00247.x
Subject(s) - medicine , thyroid , subclinical infection , endocrinology , hormone , anti thyroid autoantibodies , thyroid function , prospective cohort study , thyroid stimulating hormone , antibody , autoantibody , immunology
Aim: To investigate whether early treatment with l ‐thyroxine may prevent deterioration of thyromegaly and progression to subclinical or clinical hypothyroidism in pediatric patients with type 1 diabetes, positive thyroid antibodies, and ultrasound abnormalities of the thyroid gland. Methods: The development of thyroid gland volume and function in patients without l ‐thyroxine treatment (group A, n = 8) was assessed and compared with that in patients receiving l ‐thyroxine treatment (group B, n = 7) with median follow‐up time of 2.0 yr (range 0.6–3.0 yr). Standard deviation score (SDS) of thyroid gland volume was calculated according to gender‐ and age‐corresponding data. Results: Median thyroid gland volume SDS at study entry was 4.8 (range 2.0‐15.3) in group A and 5.6 (3.6–13.9) in group B. At follow‐up, median thyroid volume SDS has increased by 0.8 (−3.9 to 6.0) at 1 yr and by 2.0 (−4.5 to 10.9) at 2 yr in group A but decreased significantly by −3.4 (−10.0 to 0.4) and −5.3 (−12.3 to −1.7) in group B, respectively. The change of thyroid gland volume was significantly different between the two groups (p = .043 and .032, respectively). In group A, three of eight patients without therapy developed subclinical hypothyroidism with thyroid‐stimulating hormone elevation. Conclusion: These data demonstrate that treatment with l ‐thyroxine in patients with diabetes, positive thyroid antibodies, and elevated gland volume leads to a significant reduction of thyromegaly. Prospective randomized clinical trials are required to prove these preliminary findings.