Effect of iodide treatment on iodine concentration and volume of endemic non-toxic goitre in childhood.

In a total of 195 children and adolescents of both sex (mean age 12.9, range 5-17 years) with endemic non-toxic goitre the thyroidal iodine concentration (IC) was determined using X-ray fluorescent scanning on admission and during iodine (100 micrograms daily) and L-thyroxine (3 micrograms/kg body weight daily) treatment respectively. Additionally the thyroid volume was measured sonographically in a longitudinal study including 46 patients before and after 4-8 months of iodine supplementation (100 micrograms daily). The IC was 305 +/- 144 micrograms/g. It compared well with that of adult goitre patients (288 +/- 109 micrograms/g) and was significantly inferior to the value of normal controls (389 +/- 170 micrograms/g). Under L-thyroxine therapy the IC further decreased (243 +/- 144 micrograms/g), whereas patients receiving iodide showed an increase of the IC (570 +/- 197 micrograms/g). The mean TSH level fell from 2.3 +/- 0.9 microU/ml to 1.4 +/- 0.6 microU/ml. The average T4/TBG (thyroxine binding globulin) ratio showed a slight increase which, however, was not significant. The mean goitre volume decreased by 40%. It was evidenced that iodide is useful not only in the prophylaxis of non-toxic goitre but also as a more physiologic treatment than thyroid hormones, at least for young subjects with simple diffuse goitres.