NODULAR HYPERPLASIA IN TREATED CONGENITAL GOITROUS HYPOTHYROIDISM

Two patients with congenital goitrous hypothyroidism, treated since bi rth, are described, Each developed progressive nodular thyroid enlarge ment in adolescence, possibly related to ongoing thyroid stimulation d ue to slight and transient elevations of thyroid stimulating hormone ( TSH) levels, The incidence and degree of persistent thyroid enlargemen t in these patients has not been well documented. If present in a sign ificant number of patients despite appropriate L-thyroxine replacement , our therapeutic aims in congenital goitrous hypothyroidism may need to be modified to achieve TSH suppression, rather than normalization.