Prevalence of chronic lymphocytic thyroiditis in adolescent girls.

Chronic lymphocytic thyroiditis (CLT) is the most common cause of thyroid enlargement in children and adolescents in iodine sufficient areas. The prevalence and pattern of CLT in adolescent girls in iodine deficient regions supplemented with iodine is as yet not known. We therefore, carried out clinical examination for the presence of goitre in 330 healthy girls from Delhi in the age group of 16-20 years and those with goitre were further subjected to detailed biochemical (T3, T4, TSH), immunological (ATg ad ATm) and cytomorphological examination. The prevalence of goitre was found to be 40%. Fine needle aspiration cytology (FNAC) carried out in 94 girls with goitre (74%) revealed finding consistent with CLT in 13 (13.8%), colloid goitre with non-specific thyroiditis in 7 (7.4%), colloid goitre in 71 (75.5%) and specimen was inadequate in 3 (3.2%) girls. Thyroid antibodies were estimated in 114 of the goitrous subjects and both ATg and ATm were positive in 11 (9.6%) cases. Overall prevalence of CLT in this population was 4.0% and among those with goitre was 13.8%. When thyroid antibodies were also considered as an indicator of thyroiditis, prevalence rose to 14.4% among goitrous girls. Thyroid function tests were found to be within normal limits in all goitrous girls. This study for the first time reveals a high prevalence of CLT in goitrous adolescent girls from iodine supplemented region and underscores the need to study the prevalence of CLT in different age and sex groups from different regions of the country.

Iodine loss from iodised salt on heating.

Iodine deficiency disorders constitute a major public health problem in India. The national IDD control programme (NIDDCP) relies solely on iodine supplementation through fortification of common salt with potassium iodate. However, data regarding iodine loss due to high temperatures of cooking procedure is scarce. Using iodometric titration methods, we calculated iodine content of iodised salt samples subjected to incremental heat up to 350 degree Celsius. The results of the study indicate a gradual but minimal loss of iodine content from the iodised salt samples when subjected to high temperature with a maximum loss noticed being 18.5% at 350 degree Celsius. We conclude that there is minimal loss of iodine from the salt fortified with potassium iodate when subjected to heating (temperature normally attained during cooling process).

Evaluation of long-term results of two schedules of treatment for toxic multinodular goitre with radioiodine therapy (I 131).

Results of the long term effects of two schedules of radioine therapy (I131) in 130 toxic multinodular goitre patients were evaluated. Seventy five patients (group I) were treated with low doses and 55 patients (group II) with calculated high doses adjusted for thyroid weight (0.5-1 mu ci/g) and radioiodine uptake. Follow up (mean +/- SEM) was 4.5 +/- 0.4 years and 4.8 +/- 0.6 years respectively (p > 0.1). At the end of followup hyperthyroidism was successfully reversed in 87% (Group I) and 82% (Group II). In group I hypothyroidism was present in 5% of patients while it was 12.5% in group II patients. The total dose per gram of thyroid tissue was not significantly different in both the groups (0.058 mu ci +/- 0.0054 VS 0.073 +/- 0.0054 ci/g.) However in group II the number of I131 administration was significantly lower (1.5 +/- 0.2) than in group I (3.2 +/- 0.4) and the percentage of patients who were adequately treated in Group II with single dose was more as compared in group I (62% in group II versus 49% in group I) Hypothyroidism was reached in a shorter time after treatment in group II (median time 0.8 year in group II Vs 1.1 yrs in group I). Patients with positive thyroid antibodies showed a significant earlier development of hypothyroidism within six months. It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a significant low incidence of post therapy hypothyroidism in patients treated with low doses as compared to higher doses of radioiodine therapy.

Long-term results of two schedules of treatment for toxic multinodular goitre with radioiodine therapy.

Results of the long-term effects of two schedules of radioiodine therapy I131 in 130 toxic multinodular goitre patients were evaluated. Seventy five patients (group I) were treated with low doses and 55 patients (group II) with calculated high doses adjusted for thyroid weight (0.5-1 mci/g) and radioiodine uptake. Follow up (mean +/- SEM) was 4.5 +/- 0.4 years and 4.8 +/- 0.6 years respectively (P > 0.1). At the end of follow up, hyperthyroidism was successfully reversed in 78% (Group I) and 82% (Group II). In group I hypothyroidism was present in 5% of patients, while it was 12.5% in group II patients. The total dose per gram of thyroid tissue was not significantly different in both the groups (.058 mci +/- .0054 VS .073 +/- .0054 mci/g). However in group II the number of I131 administration was significantly lower (1.5 +/- 0.2) than in group I (3.2 +/- 0.4). The percentage of patients who were adequately treated in Group II with single dose was more as compared in group I (62% in group II versus 40% in group I). Euthyroidism was reached in a shorter time after treatment in group II (median time 0.8 year in group II Vs 1.1 yrs in group I) It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a significant low incidence of post therapy hypothyroidism in patients treated with low doses as compared to higher doses of radioiodine therapy.