Endemic goiter in Ethiopian Jews - Possible pathogenetic factors

Goiter size, thyroid function tests and thyroid cytology were studied in 100 immigrant Ethiopian Jews, 1-12 months after arrival in Israel on Operation Solomon (1991), who were referred for evaluation of goiter. Female-to-male ratio was 2.2:1. Hypothyroidism was rare (1%) whereas hyperthyroidism was frequently diagnosed (11%). Elevated thyroglobulin (TG) serum levels were found in 36% of the patients. Antithyroid antibodies were not detected. Thyroid cytology revealed rich colloid goiters in all patients. Thyroid carcinomata and chronic lymphocytic thyroiditis were not diagnosed. Both hyperthyroidism and elevated TG levels were found only in female patients and were equally distributed in patients maintained on either Israeli or Ethiopian diets. It is suggested that the major factors in the pathogenesis of endemic goiter in Ethiopian Jews are genetic and/or food goiterogens, with only a minor role for iodine deficiency.