SPORADIC NON-TOXIC GOITRE

Abstract

Thirty-six patients with non-toxic goiter were reviewed after a mean period of 13 yr. Initially 19 patients were iodine deficient (Group I) and 17 had normal plasma inorganic iodine [PII] (Group II). In general the iodine deficient patients had larger goiters, developed more complications (26% became hyperthyroid, hypothyroid or required partial thyroidectomy), and required more treatment. There were marked changes in thyroid function tests. In both groups thyroid uptake fell and PII rose though the final PII remained significantly lower in Group I patients. Thyroid and renal iodide clearance fell significantly in Group I patients only. In both groups the final mean total serum T3 [triiodothyronine] levels were abnormally elevated whereas the mean PBI [protein-bound iodine] levels did not change significantly during the period of study and the final mean total T4 [thyroxine] concentrations were normal. All goiters became smaller and there were no complications in patients whose goiter becme impalpable. No cases of malignancy and no post-operative recurrences of goiters were observed. The incidence of complications in those patients who persist with palpable goiters is sufficient to merit follow-up of this group.