Rongelap 8 HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11973 Area Code S16 YAphank 4-6262 08-42-34 R NAM UNIT NO) DISCHARGE SUMMARY ADMITTED: 7 November 1972 DISCHARGED: 13 November 1972 This 19-year-old Marshallese girl was admitted to this Hospital for evaluation of thyroid ,nodularity and physical condition prior to thyroid surgery. MEDICAL HISTORY: thyroid gland. Examination in September revealed nodularity in the right upper lobe of the One nodule was fairly firm and about 1 cm. in diameter and the other was smaller and soft in consistency. No lymph nodes were palpated, and the patient appeared to be euthyroid. Previous exams over the past 18 years have not revealed any thyroid abnormalities and she has always appeared euthyroid with thyroxin levels in the normal range. was noted to be anemic, cause unknown. During the September 1972 examination she She was 17 months of age at the time of exposure to fallout and received an estimated whole-body dose of 69 rade of gamma radiation and a thyroid dose of about 500 rads, largely from absorption of radiciodines in the food and water consumed, This is the first case of thyroid nodularity in children of this lower Rongelap exposure group (Ailingnae group). Immediate effects of fallout were few: development of mild superficial beta burns of the skin and slight epilation which healed within a few weeks, with normal regrowth of hair; development of mild platelet depression and leukopenia which returned to normal levels by one year, Since 1954 she has been in good health with no significant illnesses or injuries and her growth and development have been normal, Another sister, who was also exposed to fallout, developed benign thyroid adenomatous nodules which were removed surgically several years ago. PHYSICAL EXAMINATION: This slender girl is well-developed and well-nourished, The thyroid examination revealed the upper part of the right lobe to be irregular with a soft, 1.5-cm, nodule in the upper part, ‘The left lobe was barely palpable. No cervical nodes were palpated and she appeared to be euthyroid, The remainder of the Physical Examination was essentially negative except for a small papilloma in the perineum. LABORATORY & X-RAY DATA: the upper right lobe. after TSH stimulation. Thyroid scane using >°™tc showed nodularity with reduced function in T™% level was normal (9.3 ug%) and showed good increase Tie 1231 uptake was slightly elevated and the response to TSH was fair, ‘the Laboratory and X-ray data were otherwise normal except for the presence of Trichuris Trichuria in the atools, -1- bt 7204 120