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Volume 357:1263-1264 September 20, 2007 Number 12
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Recognizing Iodine Deficiency in Iodine-Replete Environments

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To the Editor: Iodine-deficiency disorders are prevalent in regions with low iodine levels but have generally been eliminated in affluent countries through the widespread use of iodized salt.1,2,3,4 We report on two women, both lifelong residents of the United States, in whom iodine-deficiency disorders developed.

Patient 1 presented with goiter and symptoms of hypothyroidism. Examination of the neck confirmed a diffusely enlarged thyroid gland (approximately 50 g); hypothyroidism was confirmed biochemically (Table 1). A radioactive iodine study, performed before her referral for endocrine evaluation, was reportedly "consistent with hyperthyroidism." The latter finding, together with a history of avoidance . . . [Full Text of this Article]



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