Treatment of diffuse euthyroid goiter in children

Abstract

High prevalence of diffuse euthyroid goiter and inefficiency of conservative treatment aimed at normalization of thyroid volume necessitate search for optimal methods of treatment. Results of thyroxin and potassium iodide (antistrumin) therapy of 110 children with diffuse toxic goiter, living in a region with medium-grave iodine deficiency, are analyzed. The diagnosis was verified by clinical data, ultrasonic examinations, and hormone measurements. Changes in the volume of the thyroid under the effect of thyroxin and antistrumin therapy could be variously directed: the involved thyroid might enlarge, shrink, or not change at all. Therapeutic effects of thyroxin and antistrumin on the degree of thyroid decrease and incidence of positive results after 6-month therapy were virtually the same. Thyroxin in a daily dose of 2.0-2.5 \xg/kg promoted a decrease and normalization of the thyroid size. Efficacy of thyroxin significantly increased if it was used longer than for 6 months. Potassium iodide (antistrumin) in a weekly dose of 2000 pg (equivalent to daily 200 pg iodine) led to decrease of goiter size and normalization of the thyroid volume. The best results were observed after a no more than 6-month course of treatment. A longer course brought about a tendency to a higher incidence of untoward effects (enlargement of the thyroid).