EUTHYROID GOITERS IN CHILDREN: CORRELATION OF NEEDLE BIOPSY WITH OTHER CLINICAL AND LABORATORY FINDINGS IN CHRONIC LYMPHOCYTIC THYROIDITIS AND SIMPLE GOITER

Abstract

All children with euthyroid goiters examined over a period of 3 years underwent study of thyroid function, needle biopsy, and measurement of thyroid antibodies. Sixty-six of 71 children studied had satisfactory biopsies of the thyroid. Of these, 43 (65%) had chronic lymphocytic thyroiditis and 23 (35%) had simple goiter as determined by histologic examination of the biopsy specimen. Elevated titers of anti-thyroid antibodies were found in 50% of the patients with thyroiditis by the tanned red cell method and in 63% by the indirect Coons method. Neither antibody was present in significant quantity in 20% of the patients. Abnormal levels of antibody were rarely detected in children with histologic evidence of simple goiter. Treatment with thyroid extract has little effect on the progression of the disease process to fibrosis and atrophy. Such treatment may be necessary to anticipate the development of hypothyroidism or for replacement if thyroid function is already diminished. There is no evidence that simple goiter is associated with hypothyroidism, and treatment of this disease with thyroid preparations is necessary only for cosmetic purposes. Needle biopsy is the most useful means for making a distinction between thyroiditis and simple goiter.