Iodized oil as a complement to iodized salt in schoolchildren in endemic goiter in Romania.

OBJECTIVE: To evaluate the long-term efficacy and possible side effects of low doses of iodized oil on iodine nutrition and thyroid function in endemic goiter in Romania. METHODS: Random selection of 214 schoolchildren aged 6-14 years. Serial measurements of urinary iodine, thyroid volume with ultrasound, serum concentrations of thyrotropin, free thyroxine, thyroglobulin and thyroid autoantibodies before and up to 2 years after the oral administration of 200 mg iodine in iodized oil. RESULTS: Urinary iodine concentrations indicated a moderate iodine deficiency before therapy, sharply increased soon after therapy and slowly decreased thereafter but remained within the normal range up to more than 1 year after therapy. The prevalence of goiter was 29% before the administration of iodized oil and 9% 1 year later. Thyroid function tests and autoantibodies were normal before and up to 2 years after therapy. CONCLUSION: A single dose of 200 mg iodine from oral Lipiodol appears adequate and safe for correcting moderate iodine deficiency in children.

A retrospective study on the treatment and evolution of Graves' ophthalmopathy.

Although Graves' ophthalmopathy (GO) seems to be unanimously considered as an autoimmune disease, its pathogenesis is still unknown. That is why the different therapeutical formulas led to ambiguous results. We think that a critical retrospective analysis on our therapeutical possibilities in GO will help us to become aware of our limits in treating this pathology. Our study performed on 123 patients with GO-stage III-IV who were admitted several times in the Thyroid Department of our Institute between 1975-1991; mean age 42 yrs (42 in men and 43 in women. One hundred and twelve patients presented GO associated with thyroid hyperfunction and 11 patients--with hypo- and euthyroidism. Thyroid status was evaluated through clinical examination and laboratory investigations (radioiodine uptake--RIU, 2h, 24 hrs, Achillean reflexogram--AR, T4, T3--radioimmunoassay-RIA). Three therapeutical formulas which were available to us were used in our subjects with GO: 1) general corticotherapy (C) was given in 77.6% of the cases; initial doses: 60-40 mg prednisone for 3 weeks followed by decreasing doses for 2 months (number of cures according to GO severity); 2) orbital radiotherapy (RT) alone was administered from the very beginning to the subjects in whom general C was not possible (7.4% of the cases); 3) general C associated with orbital RT were applied in the very severe cases of GO stage IV-VI (15% of the cases). The two available formulas acted particularly on oedematous symptoms (53% with C and 55.55% with RT alone). Muscular changes were improved by C in 30.83% and by RT only in 11.11% of the cases. It was noticed a mild positive effect on protrusion under C in only 11.66%, and under RT in 33% of the cases. The less favourable results in the cases under both C and RT can be explained by the fact that these groups included cases with stages IV-VI of GO with severe evolution. In 24% of the patients we noted an aggravation of the GO evolution regardless the therapy administered. The possible pathological relationship between the exophthalmic syndrome (ES) and hyperthyroidism (HT) is also supported by our data. The onset of ES together with HT occurred in 63% of the cases. On the other hand, we can notice that it was a more severe disease evolution when both ES and HT were associated. The treatment of hyperthyroidism led to GO aggravation (following 131I, thyroidectomy and antithyroid agents (ATD) in 43%, 52% and 29% of the cases, respectively).