THE OCCURRENCE OF MONO- AND DI-IODOTYROSINE IN THE BLOOD OF A PATIENT WITH CONGENITAL GOITER*

Abstract

CONGENITAL enlargment of the thyroid gland is occasionally seen in areas where goiter is not endemic. Although the patient usually carries the stigmata of hypothyroidism, past or present, the thyroid gland itself may have an unusually strong affinity for iodide (1, 2, 3). Oftentimes several members of the same family are afflicted. Pathologic examination of thyroid tissue usually has disclosed intense hyperplasia of the follicular epithelium, and sometimes cystic degeneration and fibrosis. The present report concerns a patient who had a progressively enlarging thyroid gland from birth. In addition to small amounts of thyroxine and tri-iodothyronine, he was secreting mono- and di-iodotyrosine into his blood. The patient (Fig. 1) was a 27-year-old unmarried clerk who was born in a village near Utrecht, Holland, which was known as a region where goiter was common at that time. He had lived in Den Haag for the previous twenty-five years. Delivery was said to have been normal, but enlargement of the thyroid gland was noticed at birth. At nine months of age daily medication with 50 to 75 milligrams of thyroid powder was begun and continued in various dosages.