THE METABOLISM OF IODINE IN 2 GOITROUS CRETINS COMPARED WITH THAT IN 2 PATIENTS RECEIVING METHIMAZOLE*†

Abstract

CONGENITAL hypothyroidism which is commonly seen in the iodinedeficient areas of the world is known as endemic cretinism. The disorder, which results from depletion of iodine in the diet of successive generations, may be accompanied by atrophy and degeneration of the thyroid gland, or by hyperplasia, fibrosis, and cyst formation (1). The pathologic end-result evidently depends upon the degree of deprivation of iodine. The type of cretinism customarily encountered in regions where goiter is not endemic is known as sporadic cretinism. Subjects of this disease may harbor a remnant of atrophic thyroid tissue, but often not a vestige of thyroid is detectable. Either the gland is congenitally absent, or the physiologic stimulus from the anterior pituitary fails for reasons which are not known. Cretins with goiter are rarely encountered in nonendemic regions. Lerman et al. (2) in 1946 described 2 goitrous brothers who had juvenile myxedema. The thyroid of one of these had a high uptake of I131-labeled iodine and, according to an analysis of a biopsy specimen, contained a low concentration of iodine. In the other, uptake was normal.