Habermann u. a.; Alimentärer Jodmangel in der Bundesrepublik Deutschland Deutsche Medizinische Wochenschrjft 10 mg Jod pro kg NaC1 Walthard 1968 (53) '944 l-{abermann u. a. Alimentärer Jodmangel in der Bundesrepublik Deutschland Dcutshe Medizin]sche Wochenschrift

In a total of 195 children and adolescents of both sex (mean age 12.9, range 5\p=n-\17 years) with endemic non-toxic goitre the thyroidal iodine concentration (IC) was determined using X-ray fluorescent scanning on admission and during iodine (100 \g=m\gdaily) and L-thyroxine (3 \g=m\g/kgbody weight daily) treatment respectively. Additionally the thyroid volume was measured sonographically in a longitudinal study including 46 patients before and after 4\p=n-\8months of iodine supplementation (100 \g=m\gdaily).The IC was 305 \m=+-\144 \g=m\g/g. It compared well with that of adult goitre patients (288 \m=+-\109 \g=m\g/g) and was significantly inferior to the value of normal controls (389 \m=+-\170 \g=m\g/g). Under L-thyroxine therapy the IC further decreased (243 \ m=+-\ 144 \g=m\g/g), whereas patients receiving iodide showed an increase of the IC (570 \m=+-\197 \g=m\g/g).The mean TSH level fell from 2.3 \ m=+-\0.9 \g=m\U/ml to 1.4 \m=+-\0.6 \g=m\U/ml.The average T4/TBG (thyroxine binding globulin) ratio showed a slight increase which, however, was not significant. The mean goitre volume decreased by 40%. It was evidenced that iodide is useful not only in the prophylaxis of non-toxic goitre but also as a more physiologic treatment than thyroid hormones, at least for young subjects with simple diffuse goitres. lodine deficiency is thought to be a main etiologic factor in the development of endemic non-toxic goitre, which by definition affects more than 10% of a given population (Dunn & Medeiros-Neto 1974). This is the case in West-Germany where a mean goitre incidence of 15% in recruits (Horster et al. 1975) and of 12.5% in adults of both sex (Olbricht et al. 1983) was found.

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The new technique of quantitative fluorescent scintigraphy was used for determining the regional distribution and concentration of stable intrathyroid iodine (127 I) in 96 patients. Average iodine concentration in normal people (20 individuals) without thyroid enlargement living in the Bavarian iodine-deficiency area was 0.38 +/- 0.07 mg/g. In 32 patients with simple goitres it was significantly lower at 0.17 +/- 0.06 mg/g. With this technique it was possible to separate two types of hyperthyroidism amongst 21 patients: those with low iodine concentration in the thyroid (0.15 +/- 0.08 mg/g) and those with high iodine concentration (0.42 +/- 0.12 mg/g) after iodine administration. The iodine concentration in decompensated autonomous adenomas in twelve patients was usually low (0.12 +/- 0.12 mg/g). On the other hand iodine concentration was high in the paranodular tissues and could be demonstrated on the fluorescent scintigram. The quality of the scintigram using this technique for concentrations below 0.1 mg/g is inadequate. In this situation good imates can be obtained by radionucleid scintgrams. The situation is reversed by previous administration of iodine.

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