Levothyroxine Use in Infants and Children with Congenital or Acquired Hypothyroidism

Contributing Editor: Marcia L. Buck, Pharm.D.; Editorial Board: Kristi N. Hofer, Pharm.D.; Michelle W. McCarthy, Pharm.D.


Pediatr Pharm. 2008;14(10) 

In This Article

Early Use in Autoimmune Thyroiditis

Levothyroxine has also recently been studied as a means of preventing the development of thyromegaly and hypothyroidism in children with autoimmune thyroiditis. In their prospective, randomized, placebo-controlled open-label trial, Karges and colleagues evaluated the effects of levothyroxine in 30 children (mean age 13.3±2.1 years) with type 1 diabetes and autoimmune thyroiditis.[12] Patients were randomized to receive levothyroxine (average dose of 1.3 mcg/kg/day) or no treatment for 24 months, followed by an additional 6 month observation period. Mean thyroid volume decreased in the treatment group, with a -0.60 standard deviation score (SDS), while it increased in the controls (+1.11 SDS, p=0.0218). Hypothyroidism developed in three treated patients and four controls.

Kordonouri and colleagues found similar results in their study of 15 children (8-17 years of age).[13] Administration of levothyroxine in 7 of the children over a 2 year period resulted in a significantly lower median thyroid volume (-5.3 versus +2.0 SDS in the untreated patients, p=0.032). Both groups of investigators concluded that additional research will be needed to further clarify the benefits of levothyroxine in this condition.


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