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June 7, 1947


JAMA. 1947;134(6):555. doi:10.1001/jama.1947.02880230065023

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To the Editor:—  All the reported cases, including those with relatively low basal metabolic rates, presented a majority of the symptoms of thyrotoxicosis such as palpitation, nervousness, sweating, heat intolerance, weakness, weight loss, tremor, warm moist palms, lidlag or widened palpebral fissures and elevated pulse pressures. The thyroid gland showed either a nodular or a diffuse enlargement. Two initial basal metabolic rate determinations were made on separate days and the lower of these was reported. With the exception of 1 patient who died, all have since responded to treatment with subsidence of symptoms and lowering of the basal metabolic rate.That 9 patients out of a small group showed basal metabolic rates under plus 15 per cent is not as important as that all presented unmistakable evidence of thyrotoxicosis.

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