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HOSPITAL OF THE MIDICAL MLSCARCH CINTER,
REQOKHAVIN MATIONAL Lasoraloay
8-45-3R
UFTOM, NEW YORK 1197]
Aves Cade Sld VApnash 6-6142
prat NO)
DISCHARGE SUMMARY
ADMITTED:
June 2, 1973
DISCHARCED:
June 10, 1973
MEDICAL HISTORY:
This Jleyeareold Marshallese woman was
found to have a small thyroid nodule
at the time of the regular annual examination of the Marshallese expused to radios
active fatlouc this past March, The nodule was pea-sized, freely movable, and Ln
the midportion vf the right lobe. There was no lymphadenopathy noted. She was
brought to the U.S. and admitted to this Hospital for thyroid studies and evaluation
for thyroid surgery. Her previous thyroid history had been negative and she had
always appeared euthyrold with low-to-normal thyroxin levels, Because of her
radiation exposure, surgical exploraticn was deemed advisable,
She was exposed on Utirik Island in 1954
to about 14 rads of gamma radiativun From
fallout with a thyrcid dose of about 22 rads (partly from radiuiudine absorption).
She showed no effecets of the slight exposure, and the principal medical findings
over the [9-year period since exposure have concerned the development of casential
hypertension with possibly slight kidney involvement, Complaints have largely
centered around arthritic pains and stiffness cf the knees and legs and the development of poor visicn.
FAMILY AND SOCIAL HISTORY:
Irrelevant.
PHYSTCAL EXAMINATION:
This slender, elderly, alert lady appeared
healthy, euthyroid,
and well-preserved for
her age. The thyroid findings were as described above and during Che March ¢xamination, Other {Lndings included an early catarace formation of the left eye and
the presence of hypertension (BP 200/96), and a moderately laws systolic murmur.
The heart was noc thought to be enlarged and there was no evidence of cardiac de~
Compensation.
Pain and stiffness 4 aoving the
associated with arthritic changes.
LABORATORY AND X-RAY DATA:
Radloactive fodine uptake was
thyroid reserve.
knees
and
lege may have been
The thyroid acan showed a “cold” nodule
at the lateral border of the right lobe,
low-normal,
and TSH administration showed reduced
Her serum was non-reactive to antithyroid gtubulin antibodies.
Chest x-ray showed cardiomegaly and aortic sclerosia;
slight
Increase
in density
Rear the cardiac apex “probably due to old Inflammatory disease", and a slight
deviation of the trachea. X-ray of che knees was negative. EKO was within normal
limits. The hemogram was normal except for 81 eosinophils and an ESR of 38.
Aldosterone level was normal. Some kidney dysfunction was evidenced by BUN of 27,
urine albumin 50 mg% with 8-12 RBC/HPF, urea clearance 552% and creatinine clearance
39%. Other clinical chemistry tests were generally negative, including tests for
liver function, electrolytes, Lipids, and serum pruteins. Stools vere positive
for ascaris lumbricoides and trichuris trichura, Syphilis serology was shightly
positive (titer of 2) buc this low level is not considered significant, particularly
in view of possible yaus in the past which was prevalent in these people.
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