Myxedema Ascites: A Rare Presentation of Uncontrolled Hypothyroidism

Khalid, Sameen; Asad-Ur-Rahman, Fnu; Abbass, Aamer; Gordon, Dwayne; Abusaada, Khalid

doi:10.7759/cureus.912

Cited by 7 publications

(9 citation statements)

References 7 publications

(24 reference statements)

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“…From the perspective of comparative pathology, the ascites and myxedema represent a well-known complication of hypothyroidism in humans (Khalid et al, 2016). This association was also confirmed in dogs, in which these morbidities coexist in at least in on case (Flood and Hoover, 2009) in which the cavitary fluid accumulation was attributed mainly to the impaired cardiac function.…”

Section: Resultsmentioning

confidence: 81%

Ascites Syndrome Associated with Hypothyroidism in a Brahma Chicken: a Case Study and Review of the Literature

Tăbăran¹,

Morar²,

Gal³

et al. 2019

BUASVMCN-VM

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Ascites syndrome (AS) in chickens represents a major cause of mortality and the most frequent metabolic-related cause of abattoir carcass condemnation in broilers. Susceptibility of broiler chickens to ascites is determined by a complex interaction between genetically-controlled factors (as high-rate metabolism and peculiarity of the cardiovascular system) and exogenous factors such as nutrition, and temperature. Endocrine imbalances, especially thyroid-gland dysfunctions, are currently regarded as key-elements in the development of AS. The current case represents the first spontaneous case of hypothyroidism (goiter) associated with AS in broilers, bringing additional arguments to the theory which claims the role of thyroid dysfunction in this syndrome. Further studies of spontaneous cases which must include assessment of the thyroid hormones need be performed in order to better understand the link between thyroid gland dysfunction and the cardiopulmonary changes in the context of AS in birds.

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Section: Resultsmentioning

confidence: 81%

Ascites Syndrome Associated with Hypothyroidism in a Brahma Chicken: a Case Study and Review of the Literature

Tăbăran¹,

Morar²,

Gal³

et al. 2019

BUASVMCN-VM

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“…One of the first cases of ascites resulting from hypothyroidism was reported in 1950 in the New England Journal of Medicine [7]. Although it is rare for ascites to develop in patients with hypothyroidism, it has been reported [8][9][10][11][12]. Watanakunakorn et al, in their study of 400 myxedema patients, reported that 15 patients also had ascites [13].…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism Manifesting as a Combination of Ascites and Malnutrition Requiring Total Parenteral Nutrition: A Unique Presentation

Zafar

Suddaby

Shafiq

2019

Cureus

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Ascites is the abnormal buildup of fluid in the abdomen. Despite appropriate workup, including diagnostic paracentesis with fluid analysis and abdominal imaging, the cause of ascites is sometimes unknown. In this case, testing for less common causes should be performed, including checking thyroid function test (TFT) because hypothyroidism has also been reported to be a rare cause of ascites. Patients may also have concomitant malnutrition as an effect of severe hypothyroidism, rather than as its cause. We report the case of a 62-year-old female with a history of hypothyroidism and non-compliance who presented with unexplained ascites and then also developed severe malnutrition, requiring total parenteral nutrition (TPN). Extensive testing, including laparotomy, was unable to reveal the cause of ascites and malnutrition until the patient mentioned, during her hospital stay, non-compliance with her home dose of levothyroxine (175 μg) because of the cost. TFT results indicated that the patient had severe hypothyroidism, with a thyroid-stimulating hormone (TSH) level of 21.9 IU/mL and a free thyroxine level (T4) level of 0.2 IU/mL. The patient’s home levothyroxine dose was resumed. The patient clinically improved and was discharged on an oral diet. The patient’s ascites resolved completely, the TSH level was 2.39 IU/mL, and the T4 level was 1.7 IU/mL at the eight-week follow-up.

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“…Вследствие повышения проницаемости капилляров, а также транссудации жидкости и альбумина не только в интерстициальное пространство, но и в другие полости у больных гипотиреозом могут развиться гидроперикард, гидроторакс, асцит [24]. Данные о количестве белка в асцитической жидкости и уровне СААГ у больных гипотиреозом, согласно разным источникам, представлены в таблице [6,12,13,25,26]. Так, у большинства пациентов уровень белка в асцитической жидкости был более 2,5 г/дл, средний показатель СААГ -1,5 г/дл.…”

Section: Discussionunclassified

“…описали случай 56-летней пациентки, которая страдала тиреоидитом Хашимото, гипотиреозом в течение 30 лет. Через шесть месяцев после прекращения приема левотироксина у нее развился асцит, появились выраженные периферические отеки [25]. Авторы провели обширное обследование для выяснения этиологии асцита.…”

Section: Discussionunclassified