Volume 27
PANEL DISCUSSION ON HYPERTHYROIDISM
TABLE 1. Examination on 207 propositi with Graves’ disease (28)
No. examined
:
’
Graves’
Simple
Myxe- Total
Mothers
Sisters
Aunts
disease
goiter
dema
6
17
10
23
1
14
Daughters
18
20
Fathers
Brothers
Uncles
3
1
Sons
1
8
>
Soir
201
363
188
213
137
22
667
2
554
377
659
26.1%. Martin and Fisher (28) studied the
families of 90 propositi with Graves’
disease. As shown in Table 2, a total of 20
cases of thyrotoxicosis and 16 of simple
goiter was found. The effect was more
marked in Graves’ disease families than in
goiter families. Again the condition was
seen more in.female relatives than in male
relatives. Finally, Boas and Ober (29)
found that 11 of 143 blood relatives in
” five generations had exophthalmic goiter.
Of this group, eight were females and three
were males. From these data, it would
appear that hyperthyroidism certainly
was more prominent in these families, but
TABLE 2. Observations in 90 families
with Graves’ disease (28)
Graves’ Toxic Simple Goiter
disease goiter goiter (? toxic)
Aunts
8
&
1
5013)
1
5
2
3
.
3
1
4
pie
Graves’ Simple
All
disease
goiter
goiters
191
248
3.5
8.2
5.2
9.7
8.7
17.9
47
9.0
17.1
26.1
581
0
2.7
Fe
3.3
%
5.9
227
547
51
propositi showed toxic diffuse goiter. Making the necessary allowance for the inequality in sex and age distribution and
estimating the risk of Graves’ disease or
toxic diffuse goiter by examining a control population, it was possible to assess
the frequency of the gene for thyroid disease at about 12.6%. As shown in Table 1,
the risk of developing goiter is greater in
females, with the risk in daughters rising to
Mothers
Fathers
Sisters
Brothers
Sons
Daughters
.
Graves
Risk of development
Total
6
0
16
8
0
1
5
did not follow an autosomal dominant
autosomal recessive, or sex-linked mode of
inheritance.
It may be worthwhile to speculate on the
possibility that hyperthyroidism may be
transmitted on the basis of a multifactorial inheritance. Most differences between normal human beings show continuous variance. For example, if 1000 men @
were arranged in order of height, each
would differ from his neighbor by an
exceedingly small amount. Yet this variation is influenced by heredity. Continuous
variation cannot be explained on the basis
of single genes, but must depend on the
combined action of a number of genes, or
of many genes.
The regressions of child on parent, or
parent on child, or sib on sib, are equal to
the numberof genes in common, and this
is also true for more remote relationships,
as shown in Table 3. Holt (30) examined
the fingerprint ridge-count resemblances
between relatives (Table 4) and found a
goodcorrelation with the theoretical number of genes in common. It is conceivable
that hyperthyroidism represents a type of
polygenic inheritance except that the condition is seen with greater frequency among
females, possibly because of a hormonal
effect.
DR. WERNER:If LATS is accepted asan
etiologic agent, and if it is accepted that
3
it might be an antibody, what would be “gill
found in the serum ofrelatives that did not