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  1. E. A. Nyenwe1,
  2. S. Dagogo-Jack1
  1. 1Division of Endocrinology, University of Tennessee Health Science Center, Memphis, TN


Iodine deficiency disorders (IDDs) are prevalent in countries and regions with decreased iodine abundance and inadequate dietary iodine intake. Over 1.9 billion people are estimated to be at the risk of IDD worldwide. IDDs have been eradicated in North America and most affluent countries through the widespread introduction of iodized salt. We report four cases of IDD in patients resident in iodine-replete regions. All four patients were young females aged 24 to 34 years. All of them had goiter, whereas two patients had hypothyroidism in addition. Every one of them was cured with dietary correction of iodine deficiency. The clinical and ancillary diagnostic features and clinical course of IDD in an environment that has long had a policy of salt iodization is highlighted. Clues to iodine deficiency include a history of chronic low salt consumption, deliberate avoidance of iodized salt, and/or avoidance of fish or seafood consumption, as well as conditions requiring increased iodine intake, such as pregnancy and lactation. These cases underscore the need for considering iodine deficiency in the etiologic diagnosis of goiter and hypothyroidism, even in iodine-sufficient regions. It is imperative that a definitive diagnosis of iodine deficiency, which is easily treatable with iodized salt, be made as this will prevent placing patients on unwarranted lifelong thyroxine therapy.

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