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Cormac
01 May 2009, 02:42 PM
I was talking to a relative (A) last night about another relative (B) that died years ago. We discussed relative B's cause of death because A was worried about the condition of B being hereditary. I have a death certificate for relative B which listed Exophthalmic goiter as the cause of death.

During our discussion, we mentioned another relative (C) who has written a book that included relative B. In this book, relative C listed B's cause of death as either a stroke or heart attack. But C does not list Exophthalmic goiter as the reason or cause of the stroke or heart attack. In an e-mail, relative C correctly stated that if not treated, Exophthalmic goiter can lead to stroke or heart attack. Btw, relative C is a lawyer.

I really don't have a question or anything like that. I guess I am throwing something out there that I have run across and see if anyone else has come across something similar.

Dennis J. Cunniff
01 May 2009, 10:10 PM
I think you'll find that the utility of death certificates depends on the wisdom and intelligence of the physician who filled them out.

Properly, the "cause of death" is the underlying condition, and that is what should be listed; however, many physicians instead wrongly list the "means of death": the mechanism by which the underlying condition caused death. When the death certificate lists "heart failure" or "heart attack" as cause of death, it may be right, but it may also be that the doctor lacked the information or the inclination to fill out the death certificate more informatively.

In the instance you cite, in modern terms, the cause of death would be hyperthyroidism, and the mechanism of death would be either stroke or myocardial infarction...

In terms of heredity, then, one would be looking for hyperthyroidism as well as other endocrine disorders, as there are a number of syndromes that combine multiple endocrine problems. With only a single instance within a family, there would be little reason to believe heredity played any significant role.