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Endemic Goiter in Misiones, Argentina: Pathophysiology Related to Immunological Phenomena

A group of 316 patients from an endemic goiter region, Apóstoles, Misiones, Argentine Republic, was studied from the immunological point of view and the results obtained were compared with various tests assaying thyroid function. A tanned red cell agglutination test (TRA) and an agar gel immunodiffusion test (AGID) were used for assaying circulating antithyroglobulin antibodies. Eighty-four per cent of the sera were positive for TRA and 56% for AGID, this being the most outstanding aspect of the study. Coincidence of results in both tests was obtained in 66% of the cases. Patients with high TRA titers showed a statistically significant increase in total serum globulins and gamma globulins when compared with low TRA titers or with values obtained in the general population. No changes in albumin values were observed. No correlation was found between immunotests, age, sex, and PB¹²⁷I. Sixty-eight per cent of the patients with high TRA titers had at the same time high thyroid ¹³¹I uptake; 63% had high conversion ratio; 65 % had a low BE¹³¹I and 59% had a normal PB131I. These results suggest that an auto-immune phenomenon accompanies iodine lack in endemic goiter, a fact which is also backed by other investigations showing release of thyroglobulin into blood in normal individuals and in certain pathological conditions with increased TSH stimulation, and also by the demonstration of increased circulating iodotyrosines in endemic goiter, in Apóstoles, Misiones.

Supported by Grant AM 04728, NIH, USPHS.

¹ Chief, Centro de Medicina Nuclear, Rawson Hospital, Buenos Aires, Argentina.

² Fellowship of French Government, Institute Pasteur, Paris.

Received September 21, 1966.

Accepted July 26, 1967.