DEFECTIVE THYROID HORMONE BIOSYNTHESIS WITH ANOMALOUS REACTION TO THYROID THERAPY: REPORT OF A CASE

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Abstract
A case is presented of an euthyroid woman with an excessively large goiter, present since childhood. A distinct discrepancy was found between total protein bound iodine and butanol extractable iodine in the serum, and an elevated part of the plasma radioactivity after a test dose of 131I was not adsorbed on ion exchange resin. However, this non-adsorbed ("protein-like") 131I was at least partly extractable with acid butanol. The fractional turnover rate of radiothyroxine was high. The possibility is raised that the pathological component was brought into the circulation as a result of an inborn defect in the thyroidal synthesis or proteolysis of thyroglobulin, and that it was composed of a number of more or less simple peptides, possibly not without some hormonal activity. The uptake of radioiodine by the thyroid was only partly suppressed by desiccated thyroid therapy, but most of the trapped radioactivity did not appear to be incorporated into organic compounds.

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