Latar belakang: Penyakit tiroiditis autoimun pada anak dapat bermanifestasi sebagai hipotiroid, hipotiroid subklinis, eutiroid atau hipertiroid. Belum ada kesepakatan pemberian terapi levotiroksin pada keadaan eutiroid, meskipun beberapa penelitian menyatakan manfaat untuk mengurangi volume tiroid, mempengaruhi fungsi tiroid serta menstabilkan proses imunologis yang berlangsung.Tujuan: Mengetahui efek pemberian levotiroksin terhadap perubahan volume tiroid, fungsi tiroid dan antibodi tiroid pada anak eutiroid dengan tiroiditis autoimun.Metode: review sistematik (metaanalisis) penelitian-penelitian pada anak eutiroid dengan tiroiditis autoimun yang diberikan levotiroksin terhadap perubahan volume tiroid. Penelusuran dilakukan dari the Cochrane Library, MEDLINE, EBSCO, Proquest, clinicaltrials.gov serta sumber-sumber lain. Kriteria inklusi adalah studi pada populasi tersebut dengan desain randomised control trials dan quasi-randomised trials dengan luaran primer volume tiroid. Dua peneliti secara independen melakukan ekstraksi data, menilai risiko bias tiap studi yang diinklusi, melakukan pooled data menggunakan random effect model dan melakukan analisis sensitivitas.Hasil: Sebanyak 48 penelitian/studi teridentifikasi dengan metode penelusuran yang disusun, setelah dianalisis didapatkan 2 (dua) penelitian (80 subyek) yang memenuhi kriteria inklusi. Hanya data volume tiroid SDS yang dapat diagregrasi dari kedua penelitian. Perbedaan perubahan volume tiroid sebesar -1,18 (IK95%; -1,65; -0,70) SDS pada pemberian levotiroksin dibandingkan kontrol. Perbedaan perubahan rerata kadar TSH, fT4, TPOAb dan TgAb antara kelompok intervensi dibandingkan kelompok kontrol adalah -0,24 mU/liter (IK95% -1,96; 1,12); -0,76 pmol/liter (IK95% -4,77; 3,25); 135,2 U/ml (IK95% -319,8; 590,2); dan -75,53 U/mililiter (IK95% -255,32; 104,26). Pemberian levotiroksin memberikan efek kejadian goiter yang lebih sedikit (3 subyek) dibandingkan dengan kontrol (17 subyek) (rasio odd 0,06; IK95% 0,01-0,28).Kesimpulan: Terapi levotiroksin pada anak tiroiditis autoimun yang eutiroid mungkin bermanfaat dalam menurunkan volume tiroid (SDS) dan risiko kejadian goiter. Terapi levotiroksin pada anak tiroiditis autoimun yang eutiroid belum terbukti mempengaruhi perubahan kadar TSH, fT4, TPOAb dan TgAb.

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Background: Children with autoimmune thyroiditis may manifest as overt hypothyroidism, subclinical hypothyroidism, euthyroid or hyperthyroidism. Although there is no consensus on treating euthyroid condition in thyroiditis autoimmune children, some studies showed efficacy of levothyroxine in decreasing thyroid volume, improving thyroid function, and stabilizing immunological process.Objectives: to determine the effect of levothyroxine on thyroid volume changes, thyroid functions and thyroid antibodies in euthyroid children with autoimmune thyroiditis.Methods: Systematic review was performed in euthyroid children with autoimmune thyroiditis. Electronic databases search (the Cochrane Library, MEDLINE, EBSCO, Proquest, clinicaltrials.gov and other sources) and non-electronic search (handsearch of journals, conference proceeding) were done. Randomised and quasi-randomised controlled trials comparing levothyroxine to control in all euthyroid children with autoimmune thyroiditis were selected. Two person independently extracted data, assessed the risk of bias, analyzed pooled data from included study by random effect model and performed sensitivity analysis.Results: Two studies (80 participants) were included from 48 studies identified from searching methods. Only thyroid volume SDS data could be aggregated. Mean difference of thyroid volume change was -1,18 (95%CI; -1,65; -0,70) SDS between levothyroxine and control. Mean difference of TSH, fT4, TPOAb and TgAb change between levothyroxine and control were -0,24 mU/liter (IK95% -1,96; 1,12); -0,76 pmol/liter (95%CI -4,77; 3,25); 135,2 U/ml (95%CI -319,8; 590,2); and -75,53 U/mililiter (95%CI -255,32; 104,26). Risk of goiter was decreasing with levothyroxine treatment (OR 0,06; IK95% 0,01-0,28).Conclusion: Levothyroxine treatment for euthyroid children with autoimmune thyroid might reduce thyroid volume (SDS) and risk of goiter. Treatment of levothyroxine do not conclusively improve changes of TSH, fT4, TPOAb and TgAb.