title: Euthyroid pretibial myxedema.
abstract: Pretibial myxedema is typically associated with clinical hyperthyroidism, diffuse goiter, and ophthalmopathy in patients with Graves' disease. A case of biopsy-proved pretibial myxedema was encountered in a clinically euthyroid woman who had neither diffuse goiter nor exophthalmos. Although serum total and free thyroxine hormone concentrations were normal, the thyroid-stimulating hormone response to thyrotropin-releasing hormone was absent. This case illustrates that pretibial myxedema may present without other more common manifestations of Graves' disease. In patients with suspect pretibial skin lesions, the thyrotropin-releasing hormone stimulation test may be required to establish the presence of subtle underlying thyroid gland autonomy and the diagnosis of euthyroid pretibial myxedema.
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000175:diagnosis; D006801:Humans; D007868:Leg Dermatoses / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D009230:Myxedema / Q000209:etiology* / Q000473:pathology; D013961:Thyroid Gland / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: D013972:Thyrotropin; D013974:Thyroxine