Niepomniszcze H, Targovnik H M, Gluzman B E, Curutchet P
J Clin Endocrinol Metab. 1987 Aug;65(2):344-8. doi: 10.1210/jcem-65-2-344.
A 71-yr-old man, clinically euthyroid, with a 570-g goiter causing severe mechanical neck compression underwent thyroidectomy. His total serum T4 level was 1.8 micrograms/dL, T3 was 200 ng/dL, and TSH was 35 microU/mL, and a perchlorate test was markedly abnormal. The excised thyroid tissue had normal peroxidase activity in the tyrosine iodinase and guaiacol assays. [131I]Iodide, given 24 h before surgery, was distributed in thyroglobulin isolated in vitro as follows: monoiodotyrosine, 71.6%; diiodotyrosine, 26.7%; T3, 1.05%; and T4, 0.65%. The [131I]iodide content of the whole thyroid homogenate was 59%. The goiter content of thyroglobulin was 94.7 mg/g tissue. The thyroglobulin reacted normally with antihuman thyroglobulin antiserum. Fresh goiter slices and slices from five normal human thyroid specimens were incubated with 10(-6) M KI and [131I]iodide (tracer) containing medium alone (basal), medium plus 1 mg/mL glucose oxidase (GO), and medium plus 10(-4) M NADPH and 10(-5) M vitamin K3 (NA-K3). The percentages of organic iodine in the slices, measured as protein-bound 131I, were: basal: goiter, 0.8%; normal, 6.9 +/- 1.8% (+/- SE); GO: goiter, 15.1%; normal, 17.4 +/- 3.1%; and NA-K3: goiter, 16.7%; normal, 4.6 +/- 1.14%. We conclude that an abnormal H2O2 supply may be the cause of the iodine organification defect in this goiter.
一名71岁男性，临床甲状腺功能正常，患有570克甲状腺肿，导致严重的颈部机械性压迫，接受了甲状腺切除术。他的血清总T4水平为1.8微克/分升，T3为200纳克/分升，TSH为35微单位/毫升，高氯酸盐试验明显异常。切除的甲状腺组织在酪氨酸碘化酶和愈创木酚测定中具有正常的过氧化物酶活性。术前24小时给予的[131I]碘化物，在体外分离的甲状腺球蛋白中的分布如下：一碘酪氨酸，71.6%；二碘酪氨酸，26.7%；T3，1.05%；T4，0.65%。整个甲状腺匀浆的[131I]碘化物含量为59%。甲状腺球蛋白的甲状腺肿含量为94.7毫克/克组织。甲状腺球蛋白与抗人甲状腺球蛋白抗血清反应正常。将新鲜的甲状腺肿切片和来自五个正常人类甲状腺标本的切片分别与仅含10(-6)M KI和[131I]碘化物（示踪剂）的培养基（基础培养基）、加1毫克/毫升葡萄糖氧化酶（GO）的培养基以及加10(-4)M NADPH和10(-5)M维生素K3（NA-K3）的培养基一起孵育。切片中以蛋白结合131I测量的有机碘百分比为：基础培养基：甲状腺肿，0.8%；正常，6.9±1.8%（±标准误）；GO：甲状腺肿，15.1%；正常，17.4±3.1%；NA-K3：甲状腺肿，16.7%；正常，4.6±1.14%。我们得出结论，过氧化氢供应异常可能是该甲状腺肿碘有机化缺陷的原因。
