Rongelap § HOVifAl OF Ind MECC AL BESLaaCH CINTIR DADORHAVEN NATIONAL CAR ATORY NAdaL) UPTON, NW TOae 197) 08-42-34 B Asean Code 514 VAphenh ¢-6147 Wet NO} CISCHARCE SUMMARY ADMITTED: 7 November 1972 DISCHARCEN: 1) November 1972 This 19-year-old Marshallese girl was admitted ro thie Hospital for wvaluacion of thyroid nodularity and physical condition prlog to thyrold surgery. MEDICAL HISTORY: Examination in September revealed nodularity in the right upper lobe of che thyroid gland, One nodule was fairly fire and about f cm. in diamecer and the other was smaller and soft in consistency, No lymph nodes were palpated, and the patient appeared to be euthyroid. Previous exaus 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 waa noced to be anemic, .ause unknown, She was 17 month of age ar the time of exposure to fallout and received an estimaced whole-body dose of 69 rads of gamma radiation and « thyroid dose of about 500 rads, largely fron absorption of radioiodines in the food and water consumed, This is the flret case of thyroid nodularity in children of this lower Rongelap exposure group (Ailingnage group). Immediate effects of fallouc were few: development of mild superficial beca burns of the skin and sifght epllation 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 wlth no signif icant ilinesses or injuries and her growth and developmenc have been normal, Another sister, vho was alao exposed to fallout, developed benign thyrold adenomatous nodules which were removed surgically several years ago. PHYSTCAL EXAMINATION: Thle slender girl ia well-developed and well-nourished, The thyroid examination revealed the upper part of the right lobe te be irregular with a aofc, I.5+-cm, nodule in che upper part, Tha lefe lobe was barely palpable, No cervical nodes were palpated and she appeared to be euthyrold, The remainder of the Physical Examination was essencially nega¢ive except for a small papilloma in the perineum, LABORATORY _& X-RAY DATA: Thyroid scans using ?°™Tc showed nodularity with reduced funcefon in the upper right lobe, TS level was normal (9.3 ug%) and showed good increase after TSH stimulation, The 1231 uptake wae alightly elevated and the response to TSH was falr, The Laboratory and X-ray data were otherwise normal excepe for the presence of Trichurts Trichuria in the atools, ele wa 7208 - 120 -