help button home button Endocrine Society JCEM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

Journal of Clinical Endocrinology & Metabolism Vol. 44, No. 3 481-490
doi:10.1210/jcem-44-3-481
Copyright © 1977 by the Endocrine Society.
This Article
Right arrow Full Text (PDF)
Right arrow Submit a related Letter to the Editor
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by GOSLINGS, B. M.
Right arrow Articles by QUERIDO, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by GOSLINGS, B. M.
Right arrow Articles by QUERIDO, A.

Hypothyroidism in an Area of Endemic Goiter and Cretinism in Central Java, Indonesia

B. M. GOSLINGS, R. DJOKOMOELJANTO, R. DOCTER, C. VAN HARDEVELD, G. HENNEMANN, D. SMEENK and A. QUERIDO

Departments of Clinical Endocrinology and Metabolism, University Hospital Leiden, The Netherlands
Chemical Pathology, University Hospital Leiden, The Netherlands
Department of Internal Medicine Diponegoro University Semarang, Indonesia
Department of Internal Medicine (III) and Clinical Endocrinology, University Hospital "Dijkzigt" Rotterdam, The Netherlands

In an area of severe endemic goiter in Central Java, Indonesia, clinical overt or mild hypothyroidism appeared to be present in 7 out of 20 cretins and also in 12 out of 94 non-cretinous subjects, all 5–20 years of age, living in the village of Sengi. Hypothyroidism was not found in a control group of 70 subjects of the same age living in Londjong just outside the edemia. In hypothyroid subjects the plasma PBI-concentration was 0.98 ± 0.32 µg/100 ml (mean ± SD) vS 2.72 ± 1.24 µg/100 ml in euthyroid subjects from Sengi and 4.86 ± 0.80 µg/100 ml in controls from Londjong. Values for T3 were 56.3 ± 31.7 ng/100 ml in hypothyroids, 140.5 ± 38.5 ng/100 ml in euthyroids from Sengi and 121.6 ± 27.4 ng/100 ml in controls. The TSH levels (geometric mean and range) in these 3 groups were, respectively, 210.1 (108.0–342), 15.6(3.0– 372) and 4.1 (0.8–7.0) µU/ml. The differences between themean concentration of PBI, T3 and TSH in the hypothyroid and euthyroid groups were highly significant (P < 0.001).

These data strengthen the clinical diagnosis of hypothyroidism in cretins as well as in non-cretinous subjects. All hypothyroid subjects had a PBI < 1.8 µg/100 ml and T3 < 120 ng/100 ml and TSH < 100 µU/ml. In 8 hypothyroid subjects, restudied 18 months after iodized oil injection, hypothyroidism was either corrected or markedly improved. It therefore appears that iodine deficiency per se in post natal life may lead to (juvenile) hypothyroidism, which can be corrected by iodine therapy. Our findings have implications for the definition and diagnosis of endemic cretinism. Not all hypothyroid subjects in an area of endemic iodine deficiency should be classified as cretins.

Received March 11, 1976.




This article has been cited by other articles:


Home page
Proc R Soc BHome page
P. J Obendorf, C. E Oxnard, and B. J Kefford
Are the small human-like fossils found on Flores human endemic cretins?
Proc R Soc B, June 7, 2008; 275(1640): 1287 - 1296.
[Abstract] [Full Text] [PDF]


Home page
Asia Pac J Public HealthHome page
T. Saito, H. Miyazaki, A. Bahar, A. Rahardjo, H. Djoharnas, Y. Katoh, Y. Kusukawa, T. Takehara, and T. Koga
Oral Health Condition and Endemic Goitre, in an Iodine-deficient Area in Bali, Indonesia
Asia Pac J Public Health, January 1, 2001; 13(1): 45 - 48.
[Abstract] [PDF]


Home page
Med Decis MakingHome page
M. S. Thompson, B. J. McNeil, R.D. Ganatra, P. R. Larsen, and S. J. Adelstein
Cost-Effectiveness of Screening for Hypo- and Hyperthyroidism in India
Med Decis Making, January 1, 1981; 1(1): 44 - 58.
[PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 1977 by The Endocrine Society