Download PDF
Nuklearmedizin 1995; 34(03): 92-99
DOI: 10.1055/s-0038-1629762
Original Article
Schattauer GmbH

Immunogenic and Non-Immunogenic Hyperthyroidism

Recent Trends in Prealpine Switzerland and in Coastal Poland
Claudine Als
1   From the Departments of Nuclear Medicine, University of Berne, Inselspital, Berne, Switzerland and of the, Szczecin, Poland
,
Maria Listewnik
1   From the Departments of Nuclear Medicine, University of Berne, Inselspital, Berne, Switzerland and of the, Szczecin, Poland
2   From the National Hospital of the Pomeranian Medical Academy, Szczecin, Poland
,
H. Rosier
1   From the Departments of Nuclear Medicine, University of Berne, Inselspital, Berne, Switzerland and of the, Szczecin, Poland
,
Elisabeth Bartkowiak
2   From the National Hospital of the Pomeranian Medical Academy, Szczecin, Poland
› Author Affiliations
Further Information

Publication History

Received: 21 October 1994

in revised form: 05 December 1994

Publication Date:
03 February 2018 (online)

Also available at
    Permissions and Reprints

Summary

Annual occurrences of immunogenic (IH) and non-immunogenic hyperthyroidism (NIH) between Berne (1976, 1982, 1991) and Szczecin (1973, 1980, 1991) were compared. Out of 21,025 patients referred for thyroid examinations, 10.1% (average) were hyperthyroid. In Berne (former endemic goiter region) and Szczecin (without goiter endemicity) IH occurred in 41% and 68%, NIH in 59% and 32% of hyperthyroid patients, respectively. Within a stable incidence of NIH in Berne, toxic adenomas (TA) decreased from 41% (1976) to 17% (1991) (p <0.005). In Szczecin, where iodine deficiency is in an early stage, the TA frequency did not change significantly: from 24% (1973) to 28% (1991). Increases of TA or of multifocal functional autonomy apparently “mark” incipient or, respectively, decreasing deficiencies in nutritious iodine. Hyperthyroid patients in Berne compared to Szczecin were older, both with IH (54 versus 45 y) and NIH (65 versus 52 y). Age at diagnosis was stable in Berne but increasing (p <0.05) in Szczecin (from 43 to 52 y).

Zusammenfassung

Immunogene (IH) und nichtimmunogene (NIH) Hyperthyreosen wurden zwischen Bern (Strumaendemie: 1976, 1982, 1991) und Szczecin (keine Struma-endemie: 1973, 1980, 1991) verglichen. Von 21025 für Schilddrüsenuntersuchungen zugewiesenen Patienten waren 10,1% hyperthyreot. In Bern und Szczecin war die IH mit 41 und 68%, die NIH mit 59 und 32% vertreten. Innerhalb einer stabilen NIH-Häufigkeit in Bern nahm das toxische Adenom (TA) von 41 % (1976) auf 17% (1991) (p <0,005) ab. Bei neu aufgetretenem Jodmangel in Szczecin veränderte sich die TA-Häufigkeit nicht signifikant: von 24% (1973) auf 28% (1991). Häufigkeitszunahmen von TA und multifokaler funktioneller Autonomie scheinen die anlaufende oder rückgänge Jodzufuhr zu begleiten. Hyperthyreote Patienten in Bern waren durchschnittlich älter als in Szczecin: mit IH 54 gegen 45 a, mit NIH 65 gegen 52 a. Das Alter bei Diagnosestellung war in Bern konstant, in Szczecin stieg es jedoch an (von 43 auf 52 a, p <0,05).

Keywords

Hyperthyroidism - iodine deficiency epidemiology - multinodular toxic goiter

Schlüsselwörter

Hyperthyreose - Jodmangel - Epidemiologie - Schilddrüsenautonomie
 

  • Literatur

  • 1 Als C, Lauber K, Rosier H. Cold iodine depletion: a stimulator of 131I uptake in differentiated thyroid carcinoma?. Eur J Nucl Med 1992; 19 (Suppl. 08) 708.
    Search in Google Scholar
  • 2 Als C, Lauber K, Brander L, Lüscher D, Rosier H. Iodine supply is unstable over time in an affluent society. Experientia (Basel), 1995; 51, in press.
  • 3 von Basedow K. Exophtalmos durch Hypertrophie des Zellgewebes in der Augenhöhle. Wschr Ges Heilk 1840; 14: 197-220.
    Search in Google Scholar
  • 4 Blum M, Shenkman L, Hollander CS. The autonomous nodule of the thyroid: correlation of patient age, nodule size and functional status. Am J Med Sei 1975; 269: 43-50.
    CrossrefPubMedSearch in Google Scholar
  • 5 Clements FW. Health significance of endemic goiter and related conditions. In: Endemic goiter. WHO. ed. Geneva: WHO; 1960: 235.
    Search in Google Scholar
  • 6 Cordido F, Vidal J, Valino D. et al. Diferente etiologia de la tirotoxicosis en funcion de la prevalencia previa de bocio. Med Clin (Bare) 1992; 99: 175-8.
    Search in Google Scholar
  • 7 Deckart H, Deckart E, Behringer F. et al. In-zidenz von Autonomie und Immunhyperthyreose vor und nach Jodsalzprophylaxe in der Region Berlin-Brandenburg. Acta Med Austriaca 1990; 17: 39-41.
    PubMedSearch in Google Scholar
  • 8 Eberhard H, Eigenmann F, Schärer K, Bürgi H. Auswirkungen der verbesserten Kropfprophylaxe mit jodiertem Kochsalz auf den Jodstoffwechsel in der Schweiz. Schweiz Med Wschr 1983; 113: 24-7.
    PubMedSearch in Google Scholar
  • 9 Emrich D, Schicha H, Bahre M. Autonomie und Hyperthyreose. In: Radioaktive Isotope in Klinik und Forschung. Höfer R, Bermann H. eds. Wien: Egermann; 1986. 17 1-6.
    Search in Google Scholar
  • 10 Freitas JE. Thyroid imaging: indications and limitations. In: Diagnostic methods in clinical thyroidology. Hamburger JI. ed. New York, Berlin, Heidelberg: Springer; 1989: 159-74.
    CrossrefSearch in Google Scholar
  • 11 Frey KW, Heinze HG, Kolb E. Radiojodbehandlung des multiplen autonomen Adenoms der Schilddrüse. Fortschr Rönt-genstr 1968; 108: 586.
    Thieme ConnectSearch in Google Scholar
  • 12 Graves RJ. Newly observed affection of the thyroid gland in females. London Med Surg J 1835; 7: 516.
    Search in Google Scholar
  • 13 Hamburger JI, Taylor CI. Transient thyrotoxicosis associated with acute hemorrhagic infarction of autonomously functioning thyroid nodules. Ann Intern Med 1979; 91: 406-9.
    CrossrefPubMedSearch in Google Scholar
  • 14 Hamburger JI. Autonomously functioning thyroid adenomas. NY State J Med 1984; 84 (Suppl. 11) 537-9.
    Search in Google Scholar
  • 15 Hamburger JL. The autonomously functioning thyroid nodule: Goetsch’s Disease. Endocr Rev 1987; 8 (Suppl. 04) 439-47.
    CrossrefPubMedSearch in Google Scholar
  • 16 Horst W, Schneider C. Angeborene Anomalien des Jodstoffwechsels. Gastroenterology 1962; 97: 24-49.
    Search in Google Scholar
  • 17 Horst W, Rosier H, Schneider C, Heinzel F, Conrad B. Differentialdiagnostik, Therapie und Pathophysiologie des toxischen Adenoms. In: Radio-Isotope in der Endokrinologie. Heilmeyer L, Hoffmann G, Keiderling W. Hrsg. Stuttgart: Schattauer; 1965: 311-8.
    Search in Google Scholar
  • 18 Horst W, Rosier H, Schneider C, Labhart A. 306 cases of toxic adenoma: clinical aspects, findings in radioiodine diagnostics, radiochromatography and histology; results of1111 and surgical treatment. J Nucl Med 1967; 8: 515-28.
    PubMedSearch in Google Scholar
  • 19 Kinser J, Rosier H. Die Radiojodtherapie des toxischen Adenoms der Schilddrüse. Ther Umsch 1973; 30 (Suppl. 10) 726-33.
    PubMedSearch in Google Scholar
  • 20 Kinser JA, Rosier H, Furrer T, Grütter D, Zimmermann H. Nonimmunogenic hyperthyroidism: cumulative hypothyroidism incidence after radioiodine and surgical treatment. J Nucl Med 1989; 30: 1960-5.
    PubMedSearch in Google Scholar
  • 21 Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland. Denmark and Iceland. J Int Med 1991; 229: 415-20.
    CrossrefPubMedSearch in Google Scholar
  • 22 Lobo LCG, Rosenthal D, Fridman J. Evolution of autonomous thyroid nodules. In: Current topics in thyroid research. Cassano C, Andreoli M. eds. New York: Academic Press; 1965: 892.
    Search in Google Scholar
  • 23 Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med 1993; 328 (Suppl. 08) 553-9.
    CrossrefPubMedSearch in Google Scholar
  • 24 Meng W, Bauch K, Knappe G. Iodine deficiency disease in the G. D. R. Endocrinologia Exper 1986; 20: 79-84.
    Search in Google Scholar
  • 25 Miller JM, Horn RC, Block MA. The evolution of toxic nodular goiter. Arch Intern Med 1964; 113: 122-38.
    CrossrefPubMedSearch in Google Scholar
  • 26 Miller JM. Plummer’s disease. Med Clin North Am 1975; 59: 1203.
    CrossrefPubMedSearch in Google Scholar
  • 27 Mordasini C, Abetel G, Lauterburg H. et al. Untersuchungen zum Kochsalzkonsum und zur Jodversorgung der schweizerischen Bevölkerung. Schweiz Med Wschr 1984; 114: 1924-9.
    PubMedSearch in Google Scholar
  • 28 Oddie TH, Fisher DA, McConahey WM, Thompson CS. Iodine intake in the United States: a reassessment. J Clin Endocrinol 1970; 30: 659-65.
    CrossrefPubMedSearch in Google Scholar
  • 29 Plummer HS. The clinical and pathological relationship of simple and exophthalmic goiter. Am J Med Sei 1913; 146: 790-5.
    CrossrefSearch in Google Scholar
  • 30 Pohl G, Galvan G, Steiner H, Salis-Samaden R. Das autonome Adenom der Schilddrüse im Struma-Endemiegebiet. Dtsch Med Wschr 1973; 98: 189-93.
    Thieme ConnectPubMedSearch in Google Scholar
  • 31 Reinwein D, Benker G, König MP. et al. Klinische Aspekte der Hyperthyreose in Gebieten unterschiedlicher Jodversorgung. Schweiz Med Wschr 1987; 117 (Suppl. 34) 1245-55.
    PubMedSearch in Google Scholar
  • 32 Riccabona G. Klinische Pathologie. In: Die endemische Struma. Pathogenese, Klinik und Prophylaxe. Riccabona G. Hrsg. München, Berlin, Wien: Urban & Schwarzenberg; 1972: 47-97.
    Search in Google Scholar
  • 33 Rosier H, Jenni C, Noelpp U, Kinser J. Gibt es das »autonome Adenom« der Schilddrüse »ohne Hyperthyreose«?. Schweiz Rundsch Med Prax 1979; 36: 1139-47.
    Search in Google Scholar
  • 34 Rosier H. Self-limiting hyperthyroidism. In: Radioactive isotopes in clinical medicine and research. Höfer R, Bergmann H, Sinzinger H. eds. Stuttgart, New York: Schattauer; 1991. 19 1-11.
    Search in Google Scholar
  • 35 Sandrock D, Olbricht T, Emrich D, Benker G, Reinwein D. Long-term follow-up in patients with autonomous thyroid adenoma. Acta Endocrinol 1993; 128: 51-5.
    Search in Google Scholar
  • 36 Savoie JC. Etude clinique et biologique de quarante-trois cas d’adénome toxique thyroïdien. Rev Fr Et Clin Biol 1961; 6: 263.
    Search in Google Scholar
  • 37 Schmid M, Schulthess H, Bürgi H, Studer H. Jodmangel ist in der Schweiz noch immer endemisch. [Iodine deficiency: still endemic in Switzerland]. Schweiz Med Wschr 1980; 110 (Suppl. 36) 1290-5.
    PubMedSearch in Google Scholar
  • 38 Sisson JC. Discussion of: Thyroid imaging: indications and limitations. In: Diagnostic methods in clinical thyroidology. Hamburger JI. ed. New York, Berlin, Heidelberg: Springer; 1989: 168.
    Search in Google Scholar
  • 39 van Soestbergen MJM, van der Vijver JCM, Graafland AD. Recurrence of hyperthyroidism in multinodular goiter after long-term drug therapy: a comparison with Graves’ disease. J Endocrinol Invest 1992; 15 (Suppl. 11) 797-800.
    CrossrefPubMedSearch in Google Scholar
  • 40 Stanbury JB, Hetzel B. et al. Endemic goiter and endemic cretinism. New York: Wiley and Sons; 1980: 606.
    Search in Google Scholar
  • 41 Studer H, Greer MA. The regulation of thyroid function in iodine deficiency: Chapter VI: Summary. Bern, Stuttgart: Hans Huber; 1966: 103-7.
    Search in Google Scholar
  • 42 Studer H, Kohler H, Biirgi H. Iodine deficiency. In: Thyroid handbook of physiology. Greer MA, Solomon DH. eds. Washington, DC: American Physiological Society; 1974. 3 303-28.
    Search in Google Scholar
  • 43 Studer H, Peter HJ, Gerber H. Natural heterogeneity of thyroid cells: the basis for understanding thyroid function and nodular goiter growth. Endocrin Rev 1989; 10: 125-35.
    CrossrefPubMedSearch in Google Scholar
  • 44 Studer H, Gerber H. Toxic multinodular goiter. In: Werner and Ingbar’s: The Thyroid. Braverman LE, Utiger RD. eds. Philadelphia, New York, London: Lippincott JB Co.; 1991. 6 692-7.
    Search in Google Scholar
  • 45 Syrenicz A, Napierala K, Celiba-fa R. et al. Iodized salt consumption, urinary iodine concentration and prevalence of goitre in children from four districts of north-western Poland. (Szczecin Coordinating Center). Endokrynol Pol 1993; 44: 344-50.
    Search in Google Scholar
  • 46 Szybiiiski Z, Nauman J, Gembicki M. et al. Principles, main goals and methods of the nationwide program: “investigations on iodine deficiency and model of iodine prophylaxis in Poland.”. Endokrynol Pol 1993; 44: 235-48.
    PubMedSearch in Google Scholar
  • 47 Wiener JD. A systematic approach to the diagnosis of Plummer’s disease (autonomous goitre), with a review of 224 cases. Neth J Med 1975; 18: 218-33.
    Search in Google Scholar
  • 48 Wiener JD, de Vries AA. On the natural history of Plummer’s disease. Clin Nucl Med 1979; 4: 181-90.
    CrossrefPubMedSearch in Google Scholar
  • 49 Wiener JD. Plummer’s disease: localized thyroid autonomy. J Endocrin Invest 1987; 10: 207-24.
    Search in Google Scholar