In 1943, Hamilton and his associates1 recognized that the measurement of iodine uptake by the thyroid may not indicate the degree of thyroid function measured in terms of thyroid hormone activity. They reported two goitrous children, both of whom demonstrated clinical and laboratory evidence of marked hypothyroidism, and yet both accumulated more than normal amounts of iodine following tracer doses of I131. At the time, because of technical difficulties, they were unable to measure circulating thyroxin. Biopsy specimens were taken from the thyroids of these patients, and radioautographs showed that in both most of the iodine was deposited in the cells of the acini rather than in the colloid and surprisingly large amounts of iodine were concentrated in the thyroid. They suggested that, "if the circulating thyroxine is extremely low or even absent in such patients, the metabolic fault must lie in the inability of the thyroid to
KUNSTADTER RH, KOHLENBRENER RM, OLINER L. Thyroid Dysfunction in Goitrous Children: Radioiodine Studies and Plasma Chromatograph Analysis for Thyroid Hormone. AMA Am J Dis Child. 1957;94(6):682–690. doi:10.1001/archpedi.1957.04030070094011
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