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October 1983

Thyroid Disease in Hemochromatosis: Increased Incidence in Homozygous Men

Author Affiliations

From the Department of Medicine, University of Utah College of Medicine and LDS Hospital, Salt Lake City (Drs Edwards, Kelly, and Kushner); and the Riverview Hospital, Idaho Falls, Idaho (Dr Ellwein).

Arch Intern Med. 1983;143(10):1890-1893. doi:10.1001/archinte.1983.00350100052015

• The thyroid function of 49 patients homozygous for the hemochromatosis allele was studied by measurement of serum thyroxine and thyrotropin concentrations. Of 34 homozygous men, three were found to be hypothyroid (thyroxine, <3.0 μg/dL and thyrotropin, >40 ImU/mL) and one was hyperthyroid (thyroxine, 24 μg/dL). All 15 homozygous women had normal thyroid function. The hypothyroid patients had elevated titers of antithyroid antibodies. Histologic examination of the thyroid at autopsy of one hypothyroid patient showed notable iron accumulation and fibrosis with modest lymphocytic infiltration. The causative importance of iron deposition in thyroid diseases associated with hemochromatosis was suggested by the reversal of the usual sex ratio of thyroid dysfunction. Men with hemochromatosis had a much greater iron load than women, and they also had a surprisingly higher incidence of thyroid disease. Iron may have caused injury to the thyroid, followed by the development of antithyroid antibodies and hypothyroidism. The frequency of thyroid disorders in men with hemochromatosis is about 80 times that of men in the general population.

(Arch Intern Med 1983;143:1890-1893)