Rongelap 51
HOSPITAL OF THE MEDICAL RESEARCH CENTER,
BROOKHAVEN NATIONAL LABORATORY
—
ADMITTED:
UPTON, NEW YORK 11973
08-50-52 R
area Code S16 YAphenk 4-6262
DISCHARGE SUMMARY
WANE
{eat NO)
CIRC 63
27 May 1974
DISCHARGED:
3 June 1974
This 45-year-old Marshallese female
was admitted for evaluation of her
thyroid statua in anticipation of possible surgery.
MEDICAL HISTORY:
In September 1973, a small nodule
0.5 cm in diameter was noted in the
region of the lower left lobe of the thyroid.
By March 1974, the nodule
appeared to have grown slightly in size.
She had always appeared euthyroid and
her T4 levels were in the normal range.
‘The patient was accidentally exposed
to fallout radiation in 1954 at age 24, She received an estimated 69 rads of
whole body gamma radiation which caused mild depression of her blood elements
during the first few weeks after exposure. Fallout contamination of the skin
caused mild, transitory, beta burns of the skin during the first few weeka also,
She also absorbed internally some radionuclides, the most serious of which were
radioiodines, She remained generally healthy until about 1970, except that she
was somewhat underweight and had an early menopause (age 42), after having had
one miscarriage and one child.
Since 1971 she has complained of frequent bouts
of coughing, dyspnea, night sweating at times, and chest pain. She hae had
white-to-yellowish sputum, but denies hemoptysis. She claims to become dyspneic
om “exertion, and during the bouts of coughing sleeps propped up on pillows.
LABORATORY & X-RAY DATA:
Thyroid scan using 123; shows a focal
area of decreased radioactivity in
the middle and lower 1/3 of the left lobe of the thyroid laterally,
Her RAI
uptake was 15.8%.
Chest x ray showed increased lung markings, possible due to
chronic bronchial disease,
Numerous exams for AFB of the sputum were negative,
both on smear and by culture,
No other consistent pathogenic organisms were
found in the sputum. ‘The EKG showed some T-wave abnormalities, which were not
necessarily considered significant. Her hem_pgram was negative except for
increased eosinophils which may have been related to the finding of whip-worm and
trichuris ¢richura in her stoola,
She had slightly increased blood proteins,
particularly globulins, which is not an unusual finding in the Marshallese
people.
She had a positive syphilis serology, reactive, titer II.
(In the
Marshallese, infection with yawa, which was endemic years ago, not infrequently
results in positive serology.)
HOSPITAL COURSE:
During the first few days of hospitalization,
the patient remained in bed
a good deat of the time. She coughed frequently and had slight increase in
respiration, bringing up a whitish-yellowish sputum. She became dyspneic on
exertion.
She had a low-grade fever in the evenings.
Her appetite was poor,
In view of possible TB infection, isolation procedures were instituted, though
subsequent teats and sputum findings did not substantifateauch a diagnosis,
Considering the possibility of bronchial infection, she was given tetracyclines
and Tedral for cough.
She improved in the last few days of hospitalization
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