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June 18, 1927


Author Affiliations


JAMA. 1927;88(25):1954-1956. doi:10.1001/jama.1927.02680510012005

All authorities are agreed on the difficulties sometimes encountered in making a differential diagnosis between pulmonary tuberculosis in the incipient or minimal stage (without definite lung signs) and early goiter when not accompanied by appreciable enlargement of the thyroid. All are agreed on the striking similarity in the symptom complex of the two conditions. In both goiter and early tuberculosis there are tachycardia, instability of the pulse, progressive loss of weight, sweating, nervous symptoms and emotional changes. As regards the metabolic rate as a means of differentiation, in some cases of tuberculosis there is a slight increase in metabolic rate almost identical with that so often seen in the forme fruste or mild type of exophthalmic goiter. Consequently, this criterion also fails us in the differentiation of these two conditions.

In both conditions are found sympathetic disturbance and loss of weight despite increased appetite. If to the foregoing syndrome there

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