Hypothyroidism is a frequent condition in medical practice and clinical forms with ascites are exceptionally rare. After a review of the literature we found that the exudative nature of the fluid is the main feature associated with hypothyroidism, however no case of hypothyroidism associated with transudative ascites has been reported. We report a case of transudative ascites associated with hypothyroidism in a post thyroidectomy setting. This 72-year-old patient underwent total thyroidectomy 3 years ago, without supplementation with synthetic thyroid hormone. He had been treated in cardiology for compensated ischaemic heart disease for 4 months. He presented with apathy, significant physical asthenia and a hoarse voice. His general condition was altered, with a rounded, puffy face and infiltrated eyelids. The feet were oedematous. Haemodynamic constants revealed arterial hypotension. Ascites aspiration yielded a sterile, pauci-cellular, citrine-yellow, transudative fluid. After ruling out renal, glomerular and hepatic causes, the ascites persisted despite optimised treatment of his heart disease, making cardiac ascites unlikely. Signs of hypometabolism and myxedema, together with a very high TSH (TSHus = 54.26 microgr/L) and disappearance of ascites after thyroid hormone supplementation, supported the hypothesis of transudative ascites associated with hypothyroidism. Ascites associated with hypothyroidism is rare and the transudative nature of the fluid is exceptional; it is generally included in myxedema. Hypothyroidism is rarely manifested by ascites but can be considered after ruling out common causes. Hormonal treatment allows complete regression of ascites within a few weeks and constitutes a therapeutic test.
| Published in | International Journal of Diabetes and Endocrinology (Volume 9, Issue 3) |
| DOI | 10.11648/j.ijde.20240903.12 |
| Page(s) | 61-64 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
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Copyright © The Author(s), 2024. Published by Science Publishing Group |
Hypothyroidism, Transudative Ascites, Myxedema
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APA Style
Barry, I. S., Diack, N. D., Ndiaye, N., Leye, A. (2024). Hypothyroidism and Transudative Ascites: Highlighting a Little-known Association. International Journal of Diabetes and Endocrinology, 9(3), 61-64. https://doi.org/10.11648/j.ijde.20240903.12
ACS Style
Barry, I. S.; Diack, N. D.; Ndiaye, N.; Leye, A. Hypothyroidism and Transudative Ascites: Highlighting a Little-known Association. Int. J. Diabetes Endocrinol. 2024, 9(3), 61-64. doi: 10.11648/j.ijde.20240903.12
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Download@article{10.11648/j.ijde.20240903.12,
author = {Ibrahima Sory Barry and Ngone Diaba Diack and Nafy Ndiaye and Abdoulaye Leye},
title = {Hypothyroidism and Transudative Ascites: Highlighting a Little-known Association
},
journal = {International Journal of Diabetes and Endocrinology},
volume = {9},
number = {3},
pages = {61-64},
doi = {10.11648/j.ijde.20240903.12},
url = {https://doi.org/10.11648/j.ijde.20240903.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20240903.12},
abstract = {Hypothyroidism is a frequent condition in medical practice and clinical forms with ascites are exceptionally rare. After a review of the literature we found that the exudative nature of the fluid is the main feature associated with hypothyroidism, however no case of hypothyroidism associated with transudative ascites has been reported. We report a case of transudative ascites associated with hypothyroidism in a post thyroidectomy setting. This 72-year-old patient underwent total thyroidectomy 3 years ago, without supplementation with synthetic thyroid hormone. He had been treated in cardiology for compensated ischaemic heart disease for 4 months. He presented with apathy, significant physical asthenia and a hoarse voice. His general condition was altered, with a rounded, puffy face and infiltrated eyelids. The feet were oedematous. Haemodynamic constants revealed arterial hypotension. Ascites aspiration yielded a sterile, pauci-cellular, citrine-yellow, transudative fluid. After ruling out renal, glomerular and hepatic causes, the ascites persisted despite optimised treatment of his heart disease, making cardiac ascites unlikely. Signs of hypometabolism and myxedema, together with a very high TSH (TSHus = 54.26 microgr/L) and disappearance of ascites after thyroid hormone supplementation, supported the hypothesis of transudative ascites associated with hypothyroidism. Ascites associated with hypothyroidism is rare and the transudative nature of the fluid is exceptional; it is generally included in myxedema. Hypothyroidism is rarely manifested by ascites but can be considered after ruling out common causes. Hormonal treatment allows complete regression of ascites within a few weeks and constitutes a therapeutic test.
},
year = {2024}
}
TY - JOUR T1 - Hypothyroidism and Transudative Ascites: Highlighting a Little-known Association AU - Ibrahima Sory Barry AU - Ngone Diaba Diack AU - Nafy Ndiaye AU - Abdoulaye Leye Y1 - 2024/09/29 PY - 2024 N1 - https://doi.org/10.11648/j.ijde.20240903.12 DO - 10.11648/j.ijde.20240903.12 T2 - International Journal of Diabetes and Endocrinology JF - International Journal of Diabetes and Endocrinology JO - International Journal of Diabetes and Endocrinology SP - 61 EP - 64 PB - Science Publishing Group SN - 2640-1371 UR - https://doi.org/10.11648/j.ijde.20240903.12 AB - Hypothyroidism is a frequent condition in medical practice and clinical forms with ascites are exceptionally rare. After a review of the literature we found that the exudative nature of the fluid is the main feature associated with hypothyroidism, however no case of hypothyroidism associated with transudative ascites has been reported. We report a case of transudative ascites associated with hypothyroidism in a post thyroidectomy setting. This 72-year-old patient underwent total thyroidectomy 3 years ago, without supplementation with synthetic thyroid hormone. He had been treated in cardiology for compensated ischaemic heart disease for 4 months. He presented with apathy, significant physical asthenia and a hoarse voice. His general condition was altered, with a rounded, puffy face and infiltrated eyelids. The feet were oedematous. Haemodynamic constants revealed arterial hypotension. Ascites aspiration yielded a sterile, pauci-cellular, citrine-yellow, transudative fluid. After ruling out renal, glomerular and hepatic causes, the ascites persisted despite optimised treatment of his heart disease, making cardiac ascites unlikely. Signs of hypometabolism and myxedema, together with a very high TSH (TSHus = 54.26 microgr/L) and disappearance of ascites after thyroid hormone supplementation, supported the hypothesis of transudative ascites associated with hypothyroidism. Ascites associated with hypothyroidism is rare and the transudative nature of the fluid is exceptional; it is generally included in myxedema. Hypothyroidism is rarely manifested by ascites but can be considered after ruling out common causes. Hormonal treatment allows complete regression of ascites within a few weeks and constitutes a therapeutic test. VL - 9 IS - 3 ER -
Department of Internal Medicine - Endocrinology - Metabolism - Nutrition, Centre Hospitalier National de Pikine, Dakar, Senegal; Department of Internal Medicine - Endocrinology - Metabolism - Nutrition, Donka National Hospital, Conakry, Rep Guinea
