[Immunogenic and non-immunogenic hyperthyroidism: attempts at a clinical differentiation]

In a retrospective study, 326 cases of thyroid hyperfunction but no scintigraphic demonstration of autonomous adenoma, were on the basis of certain primary and secondary criteria grouped as probably immunogenic or probably non-immunogenic hyperthyroid. Primary criteria were hormonal orbital signs and occurrence of thyroid antibodies. Secondary criteria concerned age, presence or absence of goitre and nodular goitre, scintigraphically silent areas and iodine contamination in relation to the onset of the disease. There was a significant difference between immunogenic and non-immunogenic hyperthyroidism by these criteria. In non-immunogenic hyperthyroidism, it is probable that suddenly raised iodine intake plays an important role in the initiation of hyperthyroid metabolic states. This was demonstrable in 82% of these patients, while in those with probably immunogenic hyperthyroidism iodine contamination (at 16%) seemed to be of less significance.