The Nontoxic Nodular Hyperplastic Goiter

Abstract

RECENT studies on sporadic goitrous cretinism^{1 2 3 4 5} have called attention to the interesting paradox of hypothyroidism associated with a hyperplastic nodular goiter. These studies have demonstrated an intrinsic defect within the thyroid gland in its synthesis of thyroid hormone that can occur at different stages, either in the binding of iodine to tyrosine or in the conversion of diiodotyrosine to thyroxin. Furthermore, judging by the different degrees of hypothyroidism in cretins, the defect in hormone synthesis may be either partial or complete. Spontaneous return of thyroid function to normal and the rarer occurrence of hyperthyroidism⁶ in some cretins suggest the possibility . . .