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Thyrotoxicosis: A Lesson From the Slaughterhouse

Thomas Pusl, MD; Hendrik Jaehnig, MD; and Robert Dorn, MD
[+] Article, Author, and Disclosure Information

From Klinikum Augsburg, 86156 Augsburg, Germany.

Potential Conflicts of Interest: None disclosed.

Ann Intern Med. 2011;155(9):646. doi:10.7326/0003-4819-155-9-201111010-00020
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Grahic Jump Location
Histology-confirmed thyroid tissue in a frozen batch of gullet meat.

HE = hematoxylin–eosin.

Grahic Jump Location




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Posted on November 3, 2011
Victor, Sloan, MD
Robert Wood Johnson Medical School
Conflict of Interest: None Declared

To the Editor:

I read with interest the Observation from Dr. Pusl and colleagues regarding exogenous thyrotoxicosis (1). The great medical journalist Berton Roueche described a similar phenomenon in his long-running column The Annals of Medicine in The New Yorker (2). In 1985, an epidemic of thyrotoxicosis in South Dakota was traced by investigators from the CDC to a meatpacking plant. Neck trimmings from the plant were being sold as 90% lean ground beef. The link was proven by, after approval by the Human Subjects Committee, having four volunteers eat cooked samples of the meat. Blood samples were obtained before and after consumption. Post- consumption samples showed the presence of thyroid hormone. This epidemic led to the US Department of Agriculture prohibiting meat processors from trimming near the gullet.

David Shore, the co-creator of the television series House M.D. has said that the lead character Gregory House was inspired in part by Roueche's writings (3).


1. Pusl T, Jaehnig H, Dorn R. Thyrotoxicosis: A Lesson from the Slaughterhouse. Ann Int Med 2011; 155: 646.

2. Roueche, B. A Lean Cuisine. The New Yorker, June 27, 1988.

3. Gibson S. The house that Dave built. University of Toronto Magazine. http://www.magazine.utoronto.ca/cover-story/david-shore-house- creator-television-producers/. Accessed November 2, 2011.

Conflict of Interest:

None declared

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