Rongelap 8 HOSPITAL OF THE BROOKHAVEN UPTON, Area Code MEDICAL RESEARCH CENTER, NATIONAL LASORATORY NEW YORK 11973 516 YAghank 4—5262 (NAME) 08-42-34 R (UNIT NO.) OISCHARGE SUMMARY ADMITTED: 7 November 1972° DISCHARGED: 13 November 1972 This 19-year-old Marshallese girl was admitted to this Hospital for evaluation ef thyroid nodularity and physical condition prior to thyroid surgery. MEDICAL HISTORY: Examination in September revealed nodularity in the right upper Lobe of the thyroid gland. One nodule was fairly firm and abouc 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. During the September 1972 examination she was noted to be anemic, cause unknown. She was 17 monthsof age at the time of exposure to fallour and received an estimated whole-body dose of 69 rads of gamma radiation and a thyroid dose of about 500 rads, largely from absorption of radiciodines in the food and water consumed, This ig che 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 placelet 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 EXAMENATION: 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, l.5S-cm. nodule in che 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 che perineum, LABORATORY & X-RAY DATA: Thyroid scans using 99, showed nodularity with reduced function in the upper right lobe. 14 level was normal (93.3 ug%) and showed good increase after TSH stimulation. The 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 stools. -1- wa 7204 - 120 - 96Go21b