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AUTONOMY IN EUTHYROID GOITRE: MALADAPTATION TO IODINE DEFICIENCY
Author(s) -
EMRICH DIETER,
BÁHRE MARTIN
Publication year - 1978
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1978.tb01502.x
Subject(s) - euthyroid , medicine , endocrinology , iodine deficiency , maladaptation , trh stimulation test , iodine , thyroid , goiter , endemic goitre , thyrotropin releasing hormone , hormone , chemistry , organic chemistry , psychiatry
SUMMARY The occurrence of negative TRH tests in euthyroid goitre was analysed in 486 patients without scintigraphic evidence of autonomous adenoma from an area of iodine deficiency. After ensuring by various means that methodological errors could be excluded, the following results were obtained. (1) The overall frequency of a negative TRH test was 15%. It increased with age of the patients, the weight of the goitre and the existence of non‐homogenity in the thyroid scan. Sex, contraceptive drugs and treatment for reduction of the goitre did not influence the number of negative TRH tests. But previous iodine medication led to a significant increase accompanied by an increase of the mean FT4 index. (2) Although in the normal range, the mean concentration of T4 and T3 in non‐premedicated TRH‐negative patients was significantly higher compared to positive ones. (3) The suppression test in patients with a negative TRH test was negative in 40% of them. These patients had higher mean values of T4 and T3 compared to those who did suppress. In connection with the findings of Miller & Block (1970) who demonstrated autonomous microscopic areas in euthyroid goitres, an hypothesis is presented that, in a certain number of iodine deficient goitres, a transition takes place from adaption through TSH‐induced hypertrophy to adaption through autonomy.