ENDEMIC GOITER IN THE UELE REGION (REPUBLIC OF CONGO). I. GENERAL ASPECTS AND FUNCTIONAL STUDIES*

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Abstract
Preliminary investigations were carried out in a widespread endemic goiter area (Uele) in the north of the former Belgian Congo. The natives were usually in poor nutritional condition. The severe endemicity was demonstrated not only by the high incidence of goiter, but also by the frequency of associated syndromes such as dwarfism, mental deficiency and cretinism. Hypothyroidism was fairly common, but no case of toxic goiter was observed. The thyroid function of 166 goitrous and nongoitrous subjects was studied by means of I127 and I131 determinations. The average thyroidal I131 uptake was 75.3 per cent of the dose after twenty-four hours, and the thyroidal clearance rate was 43.83 ml per minute. The mean value for serum I127 concentration in untreated goitrous patients was in the low-normal range (4.03 [mu]g per 100 ml), and in 56 per cent of 118 patients studied the level was below 4 [mu]g per 100 ml. Elevated PBI131 values were noted mostly in untreated young adults. All the data reflected the attempt of the thyroid gland to adapt to severe iodine deficiency; there were many cases of failure to compensate. The finding of significant amounts of triiodothyronine in the blood of 5 patients was possibly another indication of thyroidal adaptation to a lack of iodine. In natives living in the endemic area, the lack of iodine in the diet was directly demonstrated by the low urinary excretion of iodine (about 18 [mu]g daily). The iodine content of the water from the Uele region was extremely low (less than 1 [mu]g per liter). The water from two endemic zones close to the Uele region had a higher content of iodine, but it was still in the low range.