Endocrinology and Metabolism

Case Reports

A Case of Pericardiocentesis in Myxedema with Pericardial Effusion.: Min Su Kim, Dong Woo Shin, Seong Jong Kim, Seong Wook Han, Jang Ho Bae, Keun Yong Park, Kwon Bae Kim; J Korean Endocr Soc. 1999;14(1):165-170. Published online January 1, 2001

Abstract PDF: Myxedema is the nonpitting edema caused by the accumulation of glycosaminoglycans in subcutaneous and other interstitial tissue that occurs in hypothyroid patients. It is most often present in long-standing or severe primary hypothyroidism. While pericardial effusion appears to be a frequent occurrence in patients with myxedema, the development of cardiac tamponade in hypothyroid patients is distinctly unusual because of the slow formation of the pericardial effusion and the ability of the pericardium to distend. Recently we experienced a case of myxedema with pericardial effusion. The patient was 39-year-old female who was admitted due to aggrevated dyspnea for 1 month. She was obese and myxedematous. Chest X-ray revealed marked cardiomegaly. Two-dimensional echocardiography imaged massive pericardial effusion, especially left ventricular posterior wall and right ventricular side. The thyroid function test showed an obvious hypothyroid state. The patient was intubated and given controlled ventilation because of labored breathing, hypoxemia, and hypercapnea. After one half liter of straw-colored fluid was removed by pericardiocentesis, and she was given thyroid hormone replacement therapy, progressive clinical improvement was noted over course of next few weeks. We report this case with reviews of the literatures.

A Case of Autoimmune Hemolytic Anemia & Pericardial Effusion Developed in Hashimoto's Thyroiditis Patient.: Soon Jib Yoo, Moo Il Kang, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Bong Yeon Cha, Joo Yeon Choi, Kyung Ah Yoh, Ji Won Park, Jong Ryool Jin; J Korean Endocr Soc. 1998;13(4):622-628. Published online January 1, 2001

Abstract PDF: Hashimotos thyroiditis has been associated with a various autoimmune disorders. The immunologic mechanisms involved in the pathogenesis of these disorders have not always been thought to be the same. Although it was demonstrated that there were high prevalence of abnormal thyroid function and autoantibody in autoimmune hemolytic anemia(AIHA) and Fisher-Evans syndrome(FES), AIHA combined with Hashimotos thyroiditis is rare in Korean literature. It was suggested that a common immunologic mechanism may be involved in the pathogenesis of both disease and the possibility of multiple autoimmune syndrome might present in autoimmune hematologic disorders. We experienced a 74-year old woman with a 12-year history of a hypothyroidism due to Hashimotos thyroiditis was hospitalized with sudden development of warm AIHA with positive Direct & Indirect Coombs test and pericardial effusion. Her thyroid function test showed subclinical hypothyroidism with the maintenance dosage of levothyroxine(100pg/day). With glucocorticoid and plasmapheresis, AIHA and pericardial effusion were corrected successfully. It is suggested that the prudent immunologic study is needed for the anemia developed in patients with Hashimotos thyroiditis with or without hypothyroidism.

A Case of Turner's Syndrome with Hypothyroidism and Pericardial Effusion.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Jin Seok Kim, Yong Suk Yoon, Suk Ho Kwon, Jae Hyun Nam; J Korean Endocr Soc. 1997;12(4):661-666. Published online January 1, 2001

Abstract PDF: Clinical manifestations of hypothyroidism are very various and these degree are related to the severity and duration of the disease. Pericardial effusions, one of the manifestations of hypothy-roidism, were relatively common in the past. However, recently they may not be so frequent representative of hypothyroid subjects. The higher frequency of Hashimotos thyroiditis in Turners syndrome, especially those with an X-isochromosome, compared with the general population is well known. The pathophysiological process of autoimmunity is thought to be linked with the presence of an abnormal X-chromosome. Recently we experienced a case of X-isochromosome Turners syndrome with hypothyroidism and pericardial effusion and report it with reviews of the literatures.

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