Table 3 (Continued) Serum toxoplasmatiters and chorioretinal scars. d) Retinal Lesions Rongelap and Ailingnae (51) Number Utirik (98) Comparison (86) 1 % 3.9 1.0 2.3 a} Compares exposure groups, including and excluding those persons with negative tests (titers <4). b) Comparespersons tested from the four islands visited by the medical team, including and excluding the exposed from Rongelap and Ailingnae. c) Compares exposure groups according to age at the time of exposure. d) Compares exposure groups according to prevalence of chorioretinal scars. * Meanlogtiter. ** Numberof persons per group. organism rather than to a deficient immune response. Table 3c showsthat the lowest MLTs were present in Rongelap and Ailingnae persons who were<10 years and >19 years of.age at the time of exposure. No apparent clinical consequences can be related to radiation; retinal lesions which may have been due to toxoplasmosis were similar among the four exposure groups (Table 3d). NONTHYROIDAL NEOPLASMS IN EXPOSED PERSONS Pituitary Tumor A prolactinoma was diagnosed in 1981 and confirmed at surgery in 1982 in a 29-year-old Utirik woman (No. 2160X) with galactorrhea/amenorrhea. She had been exposed as an infant, but, in contrast to others, she left Utirik within 24 hours of the fallout and never returned to the atoll. The hospital summaryof her surgical admission at the National Institutes of Health can be found in Appendix IT. Retrospective assays of frozen sera saved on this patient from previous years revealed equivalent prolactin elevations as far back as 1975 (earlier sera were not available for testing). A photomicrographof the surgically removed tumoris shown in Figure 3. A nonfunctioning pituitary tumor had been diagnosed in 1976 in a 35-year-old exposed Rongelap woman and reported.’ The finding of a secondclinically significant pituitary tumor in The immuneresponse of the exposed Mar- shallese will continue to receive attention because impaired immunefunction mayplace them at greater risk for infection and perhaps for tumor development.”” Knowledge of any such risk may havea direct bearing on medical care in future years. An evaluation of tuberculin and candida skin test responsiveness is currently under way. There has been no evidence to date of autoimmune disorders. Rheumatoid arthritis has yet to be diagnosed with certainty in exposed persons. Two hundredfifty-seven persons (154 exposed and 103 unexposed) had serological evaluation for the presence of rheumatoid factor a total of 241 persons originally exposedtofall- in 1981-82. The only positive test found wasina 46-year-old Utirik man who had noevidence of out (not including those in utero) represents a high incidence for these benign neoplasms. The incidence of clinically apparentpituitary tumors in the U.S. amongpersons under 45 yearsof age approaches 1/100,000 population/year.” The rheumatic or collagen-vascular disease. This low prevalence of 0.4% contrasts with 5.2% reported for Maoris in New Zealand and 4% to 40% reported for various age groupsin the U.S.” C3 i Cc" csi 10