Hypothyroidism and Pleural Effusions

Gottehrer, Andrew; Roa, Jaime; Stanford, Gregory G.; Chernow, Bart; Sahn, Steven A.

doi:10.1378/chest.98.5.1130

Cited by 56 publications

(31 citation statements)

References 12 publications

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“…Hypothyroidism can cause pleural effusions [27]. The median and range of thyroid-stimulating hormone levels were statistically indistinguishable in the effusion vs the control groups, with 15 and 20% having chemical hypothyroidism, respectively.…”

Section: Chemical Characteristics Of Primary Systemic Amyloidosis Plementioning

confidence: 84%

Pleural effusions in systemic amyloidosis

Berk

2005

Current Opinion in Pulmonary Medicine

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Large pleural effusions in systemic amyloidosis occur most often in primary systemic amyloidosis, predominantly resulting from direct infiltration of the parietal pleural surface. Left atrial hypertension from primary systemic amyloidosis cardiomyopathy contributes to but is not sufficient to form and sustain these effusions. Untreated patients have a median survival of 1.6 months. Secondary, familial, and senile systemic amyloidosis do not infiltrate the pleural surfaces or induce pleural effusions in a clinically significant fashion.

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Section: Chemical Characteristics Of Primary Systemic Amyloidosis Plementioning

confidence: 84%

Pleural effusions in systemic amyloidosis

Berk

2005

Current Opinion in Pulmonary Medicine

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“…Since then, several publications have reported on the association between hypothyroidism and pericardial effusion, and even other serous effusions 5 . Pericardial effusion is considered the most frequent cardiovascular complication of hypothyroidism, with a prevalence estimated to be between 30% and 80% 1,2 .…”

Section: Discussionmentioning

confidence: 99%

Pericardial Effusion with Cardiac Tamponade as a Form of Presentation of Primary Hypothyroidism

Rachid¹,

Caum²,

Trentini³

et al. 2002

Arq. Bras. Cardiol.

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“…But in our case effusion is transudative. Gottehrar et al reported that pleural effusions because of hypothyrodism were borderline between exudates and transudates and showed little evidence of inflammation [9]. This is rare case of hypothyroidism primarily presenting as massive pericardial effusion.…”

Section: Mechanism Of Effusions In Hypothyroidismmentioning

confidence: 81%

Massive Pericardial Effusion-Rare and Only Presentation of Hypothyrodism- Myxedematous Heart

Sondhi¹,

Bhardwaj²,

Kandoria³

et al. 2017

J Cardiovasc Dis Diagn

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Cardiovascular symptoms are often predominant features in patients with hyperthyroidism. But cardiovascular findings in hypothyroidism are more subtle. Hypothyroidism mainly presents as lethargy, cold intolerance, constipation, proximal muscle weakness, weight gain, decreased appetite, coarse dry skin, hair loss and nonpitting edema. Cardiovascular findings in hypothyroidism are mild degree of bradycardia, diastolic hypertension and narrow pulse pressure. Mild degree of pericardial effusion is seen in up to 30% of overtly hypothyroid patients. There are several case reports on myxedema ascites, but only few case reports of hypothyroidism presenting as massive pericardial effusion. We report a case of 54-year-old female presenting with breathlessness and found to have massive pericardial effusion without tamponade. After extensive workup, she was found to have primary hypothyroidism. In contrast, she had no other symptoms and clinical signs suggestive of hypothyroidism. She was improved after treatment with levothyroxine. Keywords: Hyperthyroidism; Pericardial effusion; Levothyroxine Case PresentationA 54-year-old female (weight 49 kg; BMI 18 kg/m 2 ) presented to our department with class 2 breathlessness for last 6 months which had progressed to class 3 for last 1 month. She had no previous history of diabetes, hypertension and coronary artery disease. Vitals showed, blood pressure of 110/70 mmHg, heart rate of 112/min, respiratory rate of 20/min, SpO 2 of 94% and she was afebrile. Her general physical examination was normal, JVP was not raised and there was no pedal edema. Cardiovascular examination showed only muffled heart sounds, respiratory system was normal and on neurological examination her tendon reflexes were not delayed.On investigations, electrocardiogram showed low voltage complexes, chest X-ray showed water bottle heart (Figure 1) and on echocardiography there was massive pericardial effusion without evidence of diastolic collapse of right atrium and right ventricle. Thickness of pericardial effusion in apical 4 chamber view was 33 mm (Figure 2), in parasternal long axis view was 31.8 mm (Figure 3) and in parasternal short axis view was 21.5 mm (Figure 4). Hb was 13 gm%, ESR 21 mm 1 st hr, urea 31 mg/dl, creatinine 0.9 mg/dl, serum proteins (total 6.5 gm/dl, albumin 3.5 gm/dl), SGOT 31 IU, SGPT 35 IU, ANA was negative and urine examination was also normal.

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Hypothyroidism and Pleural Effusions

Cited by 56 publications

References 12 publications

Pleural effusions in systemic amyloidosis

Pleural effusions in systemic amyloidosis

Pericardial Effusion with Cardiac Tamponade as a Form of Presentation of Primary Hypothyroidism

Massive Pericardial Effusion-Rare and Only Presentation of Hypothyrodism- Myxedematous Heart

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