Iodine Deficiency–Induced Goiter in Central New Jersey: A Case Series

ABSTRACT Objective: We report 4 cases of iodine deficiency– induced goiter in minority women living in central New Jersey. Methods: Clinical presentations, laboratory data, thyroid 123I uptake, and thyroid sonograms were obtained from 4 minority women with iodine deficiency–induced goiter. The recent literature on the topic was also reviewed. Results: Four patients were diagnosed with iodine deficiency–induced goiter during a 4-year period in an endocrine clinic in central New Jersey. The diagnosis of iodine deficiency–induced goiter was made if the patient met the following criteria: (1) a diet history that indicated avoidance of iodized salt or seafood; (2) a 24-hour urinary iodine concentration of <100 μg; and (3) a decrease in the size of the goiter determined by ultrasonography of the thyroid after iodine replacement. Thyroid volume was calculated as width × length × height × π/6 cm3. Three of the four patients had an increase in radioactive iodine uptake. Conclusion: Iodine deficiency–induced goiter still occurs in New Jersey, the residents of which are supposedly iodine replete. It is important to obtain dietary history during the evaluation of patients with euthyroid goiter, especially in minority women. Measurement of urinary iodine excretion is warranted in suspicious cases. Iodine deficiency–induced goiter can be treated by adding iodized salt to the diet. Abbreviations: T4 thyroxine TSH thyroid-stimulating hormone