PEDIATRICS Vol. 6 No. 6 December 1950, pp. 908-918
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Round Table Discussion

ENDOCRINE THERAPY IN CHILDHOOD

WILLIAM A. REILLY M.D., LAWSON H. WILKINS M.D., WILLIAM C. DEAMER M.D., WILLIAM G. MOTEL M.D., and HARRY F. DIETRICH

Chairman Reilly: The first topic that I want to discuss with you is thyroid extract, its indications and usage. This sounds like a hackneyed subject but still there is a great deal of misusage and misinformation about thyroid.

The first thing about thyroid that might be of use to you is its preventive usage. In pregnancy it is probably advisable in the endemic areas where goiter and iodine deficiency occur to give some iodine. I am going to be very dogmatic and didactic and hope that our fellow participants will disagree, if they care to. A good many physicians feel, and I agree, that the pregnant woman should be given a little thyroid substance if it is properly indicated.

Now for the therapeutic use of thyroid. First, the indications are as follows: It is unnecessary to state to you gentlemen that you do not have to use thyroid extract for thyrotoxicosis. I have seen that happen very recently in a child with a great thyroid overactivity and carditis; some one administered a tremendous amount of thyroid inducing further decompensation of the heart. The prime indication for thyroid therapy is real hypothyroidism. Other conditions that still might be indications for thyroid are nephrosis, eczema, ichthyosis, obesity and perhaps prematurity. I am going to be very dogmatic about mongolism. Thyroid extract in mongolism has no use unless the mongol has hypothyroidism. I want to decry the use of thyroid in mongolism, although I have no better therapy. However, I do give it a trial, if for no other reason than to demonstrate to the parents that thyroid will not benefit their child.