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Recently, Liel and Alkan¹ reported 2 cases of thyrotoxicosis in young adults who had used iodine-containing preparations to purify water during backpacking trips to Central and South America ("travelers' thyrotoxicosis"). Interestingly, in both cases, serologic test results were positive for thyroperoxidase antibodies, and 1 patient had a family history of immune thyroid disease. The authors postulated a form of iodide-induced thyrotoxicosis, reflecting an inadequate response to an iodide excess in association with a presumed preexisting, asymptomatic, autoimmune thyroid disease. However, this underlying thyroid disease was not serologically or histologically documented in either of the 2 patients.

We report an analogous case with serologically and histologically documented, preexisting, asymptomatic, autoimmune thyroid disease. The patient, a 30-year-old woman, was referred to our division in December 1996 because thyrotoxicosis had been detected 1 month after she had returned from a trip to South and Central America. The patient reported headache, weight loss (3 . . . [Full Text of this Article]

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