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JOHN B. STANBURY, ALICE N. HEDGE, A STUDY OF A FAMILY OF GOITROUS CRETINS, The Journal of Clinical Endocrinology & Metabolism, Volume 10, Issue 11, 1 November 1950, Pages 1471–1484, https://doi.org/10.1210/jcem-10-11-1471
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Abstract
Apatient with cretinism encountered in an iodine-deficient area usually has an enlargement of his thyroid gland (1). Microscopically it may show all degrees of nodularity, hyperplasia and involution (2). Unless completely degenerated, such a gland might be expected to have a normal or increased avidity for iodide and to bind it readily into an organic complex. By contrast, sporadic cretinism is usually not associated with goiter; there may be only a fibrous remnant to mark the site of the gland. Little or no accumulation of radioactive iodine can be demonstrated in the gland of such a patient (3). Much more rarely one encounters a cretinous subject who is clearly not deficient in iodine, who has been exposed to no known goitrogen, and yet who shows striking enlargement of his thyroid gland. Hamilton and associates (3) refer to 2 classic cases. Following the'administration of radioactive iodine abnormally large collections of this material were noted in the thyroid glands of these patients. Two cretin brothers with goiter were studied by Lerman, Jones and Calkins (4). Histologic examination of biopsy specimens demonstrated areas of intense hyperplasia. These patients concentrated 87 per cent and 58 per cent of tracer doses of radioactive iodine in the region of their thyroids. One had the low concentration of 0.07 milligrams per cent of protein-bound iodine in the removed thyroid tissue. These findings suggested that the thyroids of these patients were unable to utilize iodine.
