Myxedema ascites. Report of two cases and review of the literature.
Ascites is a well-known but uncommon occurrence in hypothyroid patients. We describe two patients with clinical ascites that resolved completely on thyroid replacement therapy. Our review of the literature found 21 well-documented cases of myxedema ascites. Prominent features of this condition include a high protein content of the ascitic fluid (greater than 2.5 g/dl), a high albumin serum-ascites gradient, a long duration of the ascites, and its resolution on thyroid replacement. We also found a slight female predominance. The exact mechanisms responsible for ascites accumulation are unknown and some of the hypotheses are discussed. We conclude that ascites associated with hypothyroidism is rare but must be recognized early since thyroid replacement is definitive therapy.
Division of Gastroenterology, University of Missouri-Kansas City School of Medicine, MO 64108.
F
F
de Castro
M
M
Bonacini
J M
JM
Walden
T T
TT
Schubert
D000328:Adult; D001201:Ascites / Q000097:blood / Q000209:etiology*; D001202:Ascitic Fluid / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009230:Myxedema / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D011506:Proteins / Q000032:analysis; D013960:Thyroid Function Tests; D013974:Thyroxine / Q000627:therapeutic use
D011506:Proteins; D013974:Thyroxine