Congenital euthyroid goitre with impaired thyroglobulin transport.

A case of congenital goitre with defective thyroglobulin (Tg) synthesis was studied from the clinical, biochemical and morphological perspectives. The patient, 5.5-year-old boy, who was clinically euthyroid, showed a positive perchlorate discharge test (37.2%). However, the iodination system seemed to be normal since radioiodine uptake into the thyroid was very high, and inspection of the H2O2-generating system using thyroid slices and an assay for peroxidase activity in microsomes showed no abnormalities. On the other hand, virtually no Tg was detected in the serum, and the amount of Tg in thyroid tissue, estimated with gel electrophoresis, was below 10% of the normal value, the quality of Tg being unchanged. Morphological observations demonstrated the presence of Tg in the markedly distended rough endoplasmic reticulum of the cytoplasm of follicular cells and a lack of Tg in the colloid of the follicular lumen. These results suggest that the thyroid is defective in Tg synthesis, probably associated with impaired transport of Tg from the cells to the lumen.