Dear Madam,

I have read with great interest, the article \'Iodine Induced Thyrotoxicosiscase reports and review of literature by S.M.Khan Paindakhel and colleagues (JPMA May, 1980) and would like to make a few comments.
The definition of Goitre has not been clearly delineated. Goitre per se, just means enlargement of the Thyroid gland, which could be associated with hypo, eu or hypersecretion of the Thyroid gland. I presume that what the authors mean when they say Goitre, is iodine deficiency Goitre. Firstly, this is the commonest form of Goitre seen in Pakistan, and secondly the Jod-Basedow phenomena which they mention has been described only in those cases of endemic Goitre which on treatment with Iodine developed signs and symptoms of thyrotoxicosis.
Again, the authors have not mentioned, whether the patients studied had signs and symp­toms of thyrotoxicosis before they were given Lugols iodine. They have presumed that the Goitre was non-toxic, just because they had been given Lugols iodine. It is equally possible that in the cases mentioned by them, there was already thyrotoxicosis for which they were given Lugols iodine, which was a recognized practice in the past years.

Sind Medical College Karachi.
Gulshan Abdullah