exposure, the results on four other exposed, unoperated individuals had a single TSH determination >6 w/ml. All of these individuals had TRH~induced TSH
responses beiween 30 and 35 }§/ml. Therefore it is possible that in the next
few years additional individuals will be identified who meet the criteria for
biochemical thyroid dysfumction. None of the subjects with elevated serum TSH
had detectable antithyroglobulin or thyroid antimicrosomal antibodies.
3.

Thyroid Abnormalities in Cases Exposed In Utero

In the Rongelap group, exposed to 175 rads of whole-body radiation,
there were three people exposed in utero. Benign tumors of the thyroid have
been removed from two of these: adenomatoid nodules removed at age 24 from a
male (No. 83) exposed at the end of the second t.imester, and a hyperplastic
nodule removed at age 26 from a male (No. 85) exposed at the end of the first
trimester. A female (No. 86) exposed in the first trimester has developed no
detectable thyroid abnormalities. In the Ailingnae group (69-rad whole body
exposure) there was one exposure at the end of the first trimester, and in the
Utirik group (14-rad whole body exposure) there were six in utero exposures.
No thyroid abnormalities have appeared in any of these cases.
The total thyroid doses in these cases cannot be accurately estimated.
“he function of the fetal thyroid at the time of exposure is an important factor in such estimations. A few reports are available concerning function of
the fetal thyroid gland at various stages of gestation (134-137). The gland
is thought not to accumulate iodine before the 12th week of gestation, but
thereafter becomes increasing.y active, and at birth is more active than in

the adult or child. In case No. 83, at the time of exposure -- 22 weeks gesta—
tion — the thyroid was probably functioning sufficiently to have absorbed a
Significant amount of radioiodines from the mother's blood. In case No. 85,
it is unlikely that the thyroid was sufficiently functional at 12 weeks gestation to have absorbed a significant amount of radioiodines from the mother,
and the development of the thyroid nodule may have been associated with the
gauma exposure. Data on the time of gestation and degree of exposure in the
$ix Utirik cases are uncertain, but their thyroid doses both from whole-body
and from possible radioiodine exposure would have been far less than those of
the Rongelap group, and this is consistent with the lack of findings in that
group.

° Neither of the in utero exposed children who developed thyroid nodules

showed any impairment in growth and development (see Section IV). No. 83 had
an elevated TSH level prior to surgery, but without evidence of clinical
hypothyroidism. The thyroid status of the mothers of the two in utero cases
who developed thyroid nodularity is of interest. The mother ofNo. 83 was ex—
posed at age 15 to an estimated thyroid dose of 175 rads ganma radiation plus
250 rads from radioiodines and developed a thyroid cancer at age 32.

She

showed evidence of biochemical hypothyroidism prior to surgery (Section

IX.C.2.).

The mother of No. 85 was exposed at age 17 to an estimated thyroid

dose of 175 rads gamma radiation plus 160 rads from radiociodines. She has not
developed nodularity of the thyroid gland, but hypertrophy of the pyramidal
lobe at age 43 was noted.
A number of cases of myxedema have been reported following in utero expogure during treatment of the mother with large doses of radioiodines for
hyperthyroidism (mCi amounts, compared With probable UCi amounts in the

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