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Journal of Clinical Endocrinology & Metabolism, Vol 66, 376-382, Copyright © 1988 by Endocrine Society

ARTICLES

Thyroid, parathyroid, and salivary gland evaluations in patients exposed to multiple fluoroscopic examinations during tuberculosis therapy: a pilot study

MM Kaplan, JD Boice Jr, DB Ames and M Rosenstein
Department of Medicine, New England Medical Center Hospital, Boston, Massachusetts 02111.

The prevalence of thyroid, parathyroid, and salivary abnormalities was determined in 91 women who received an average of 112 fluoroscopic chest examinations during pneumothorax treatment for tuberculosis more than 40 yr previously and in 72 women treated for tuberculosis by other modalities. Thyroid abnormalities were determined by physical examination, scintiscans, and measurements of serum free T4 index, TSH, and thyroid microsomal antibodies. Thyroid nodules were diagnosed in 7.7% of the exposed and 4.2% of the comparison group (prevalence ratio, 1.8; 90% confidence interval 0.6-5.7). Autoimmune thyroid disease was diagnosed in 15.2% of the exposed and 6.9% of the comparison group (prevalence ratio, 2.2; 95% confidence interval, 0.8-6.2). No salivary tumors were detected. Two exposed women and 1 comparison woman had primary hyperparathyroidism. Although absorbed dose to the thyroid could not be precisely determined, approximately 60 rads would be expected to yield the observed excess of thyroid nodules. While the prevalence ratios were not significantly increased in the exposed group, the results suggest that susceptibility of the thyroid to nodules from cumulative radiation doses of this magnitude could be increased even when the doses are accumulated over years and that such x-ray exposure of the thyroid gland may predispose the patient to the development of autoimmune disease.


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S. Davis, K. J. Kopecky, T. E. Hamilton, L. Onstad, and and the Hanford Thyroid Disease Study Team
Thyroid Neoplasia, Autoimmune Thyroiditis, and Hypothyroidism in Persons Exposed to Iodine 131 From the Hanford Nuclear Site
JAMA, December 1, 2004; 292(21): 2600 - 2613.
[Abstract] [Full Text] [PDF]


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