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SPORADIC NON-TOXIC GOITRE

Thirty-six patients with non-toxic goitre were reviewed after a mean period of 13 years. Initially 19 patients were iodine deficient (Group I) and 17 had normal plasma inorganic iodine (Group II). In general the iodine deficient patients had larger goitres, 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 levels were abnormally elevated whereas the mean PBI levels did not change significantly during the period of study and the final mean total T₄ concentrations were normal.

All goitres became smaller and there were no complications in patients whose goitre became impalpable. No cases of malignancy and no postoperative recurrences of goitre were observed.

It is suggested that the incidence of complications in those patients who persist with palpable goitres is sufficient to merit follow-up of this group.

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				L. R. Petrone A Primary Care Approach to the Adult Patient With Nodular Thyroid Disease Arch Fam Med, February 1, 1996; 5(2): 92 - 100. [Abstract] [PDF]