Abstract
MANIPULATION of the thyroid gland during surgery, with the consequent release into the circulation of significant amounts of preformed thyroid hormone, has been suggested as a possible factor in the genesis of postoperative “storm” (1–4). In addition, it has been postulated that a definite correlation exists between the magnitude of this phenomenon and the severity of the postoperative reaction (1, 5). Reports of data obtained prior to the use of radioactive iodide in the assessment of thyroid function are conflicting in regard to changes in serum proteinbound iodine levels under these circumstances (1, 5–9). Measurements of the renal excretion of stable iodide have demonstrated a significant increase immediately following both thyroid (7, 10) and non-thyroid surgery (11, 12). That elevations of protein-bound iodine concentration can occur in response to therapeutic doses of radioiodide (13) and irradiation of the thyroid gland with radium or x-rays (5, 14) seems well documented.
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