deficiency.

However in the past two years the 2 boys showing the greatest

growth retardation have developed characteristics of frank hypothyroidisn
with atropy of the thyroid gland, drop in PBI level to less than 2 pgi,
development of coarse facial features, dry skin and Afchilles reflex with
sluggish return and bone disgenesis.
a primary hypothyroidism.

High pituitary TSH levels indicated

Several other children with less degree of growth

retardation have recently shown some degree of thyroid deficiency also.
In view of the seriousness
of these findings it was decided to
Fousne
initiate thyroid hormone therapy on the exposed people.

The rational

now for this form of therapy was that by furnishing normal levels of
exogenous thyroid hormone, pituitary TSH levels would be repressed and
remove the thyroid gland from stimulation of that hormone.

It is thus

hoped that further development of nodules and possible malignancy might

be prevented and of equal importance enhancement of growth and development
in the children might result.

Conclusive results of this treatment must

await further observations and a stricter treatment regimen.

However it

does appear that several nodules have reduced on this treatment and some
children may be showing increased growth.

The next slide shows the results

of hormone treatment on the 2 boys who had shown growth retardation, referred
to before.

It can be seen that there has been a spurt in skeletal development

coincident with the institution of the thyroid therapy.
The exclusive development of these thyroid abnormalities in the
irradiated Marshallese children seems clearly to indicate the radiation etiology.
The development of such abnormalities is consistent with the known etiological
relationship of irradiation of the thyroid gland and the development of such
lesions.

The high incidence in the children is probably related to the larger
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