THE BLOOD PICTURE IN EXOPHTHALMIC GOITRE AND ITS CHANGES RESULTING FROM IODINE AND OPERATION. A STUDY BY MEANS OF THE SUPRAVITAL TECHNIQUE

Abstract

The blood pictures of 30 untreated exophthalmic goiter patients and the effect of rest, iodinization and operation on the blood picture in 18 cases were studied by the method of Sabin for supravital blood examination. This method made possible better differentiation of the large lymphocyte, monocyte and mono-lobed granulocyte than did the fixed smear. Leukopenia, hypopolynucleosis, slight relative lymphocytosis and marked relative and absolute mononucleosis were quite characteristic of exophthalmic goiter. No correlation existed between the height of the leukocyte count and the basal metabolic rate. The percentage of polymorphonuclear cells shows a direct correlation with the height of the metabolic rate, while the percentage of lymphocytes showed an inverse relationship. The percentage of monocytes tended to vary with the height of the metabolic rate. In general, iodinization caused a decrease in the total white blood cells, a slight increase in polymorphonuclear cells and a slight decrease in lymphocytes. The most constant effect was a decrease in percentage and absolute number of monocytes. Operation per se caused very little permanent change in the blood picture. There was a rise in the total white blood cells immediately after operation. The polymorphonuclear cells and monocytes were both temporarily increased at that time. The elevated monocyte count and its depression by iodine were interpreted in the light of Aschoff''s theory of the origin of the monocyte as evidence for an activated reticulo-endothelial system in exophthalmic goiter and for a depression of that system in the course of the remission produced by iodine.