title: Clinical features and pathogenesis of thyrotoxicosis in adult Melanesians in Papua New Guinea.
abstract: OBJECTIVE
  To investigate the cause of an apparent increase in the incidence of thyrotoxicosis in the Melanesian population of the coastal areas around Port Moresby, Papua New Guinea.
  
  
  METHODS
  Consecutive patients attending the thyroid clinic at Port Moresby General Hospital were included in the study which collected clinical and immunogenetic data.
  
  
  METHODS
  One hundred and ninety-four patients with thyrotoxicosis were studied. The mean age was 31 years. The clinical features were typical for thyrotoxicosis apart from increased pigmentation, which occurred in the majority of patients and which reversed with treatment with antithyroid drugs and resolution of the thyrotoxicosis.
  
  
  METHODS
  Antibodies to thyroid peroxidase, thyroglobulin and the thyrotropin receptor were present in 99%, 52% and 69% of patients, respectively, confirming that all cases were caused by autoimmune thyroid disease. Fine needle aspirations in 42 of 43 patients were consistent with Graves' disease.
  
  
  CONCLUSIONS
  The cause of this apparent sudden increase in Graves' disease in the coastal region around Port Moresby, an apparently iodine-replete area, remains unexplained.
authors.affiliation: Research and Development Laboratory, Department of Pathology, Royal Melbourne Hospital, Western Healthcare Network, Victoria, Australia; Division of Medicine, University of Papua New Guinea, Port Moresby General Hospital, Papua New Guinea.
authors.forename: V P
authors.initials: VP
authors.lastname: Michelangeli
authors.forename: G
authors.initials: G
authors.lastname: Pawape
authors.forename: A
authors.initials: A
authors.lastname: Sinha
authors.forename: K
authors.initials: K
authors.lastname: Ongugu
authors.forename: D
authors.initials: D
authors.lastname: Linge
authors.forename: S H
authors.initials: SH
authors.lastname: Sengupta
authors.forename: B
authors.initials: B
authors.lastname: Tait
authors.forename: P G
authors.initials: PG
authors.lastname: Colman
mesh_terms: D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D001707:Biopsy, Needle; D005260:Female; D006111:Graves Disease / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology / Q000276:immunology; D015994:Incidence; D007453:Iodide Peroxidase / Q000276:immunology; D008297:Male; D010219:Papua New Guinea / Q000453:epidemiology; D011989:Receptors, Thyrotropin / Q000276:immunology; D013954:Thyroglobulin / Q000276:immunology; D013960:Thyroid Function Tests; D013971:Thyrotoxicosis / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology
chemical_list: D001323:Autoantibodies; D011989:Receptors, Thyrotropin; D013954:Thyroglobulin; D007453:Iodide Peroxidase