title: Localized myxedema, associated with increased serum hyaluronic acid, and response to steroid pulse therapy.
abstract: A 66-year-old man presented with Graves' disease and widespread localized myxedema. Extensive lesions were present on the legs, feet, hands, and face. TSH receptor antibody (TBII) was markedly positive and the serum hyaluronic acid level was very high. Intravenous steroid pulse therapy was followed by oral therapy with gradual tapering. This regimen markedly improved the skin lesions and resulted in a decrease of the serum hyaluronic acid level. The findings suggest that steroid pulse therapy is effective for the treatment of extensive localized myxedema. In addition, the serum hyaluronic acid level may be a useful parameter for the follow-up of patients with this condition.
authors.affiliation: Department of Internal Medicine, Saga Medical School.
authors.forename: Y
authors.initials: Y
authors.lastname: Ohtsuka
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Goto
authors.forename: T
authors.initials: T
authors.lastname: Mizuta
authors.forename: I
authors.initials: I
authors.lastname: Ozaki
authors.forename: Y
authors.initials: Y
authors.lastname: Setoguchi
authors.forename: H
authors.initials: H
authors.lastname: Kohda
authors.forename: T
authors.initials: T
authors.lastname: Sakai
mesh_terms: D000284:Administration, Oral; D000368:Aged; D004359:Drug Therapy, Combination; D006111:Graves Disease / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D009230:Myxedema / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D011239:Prednisolone / Q000627:therapeutic use*
chemical_list: D006820:Hyaluronic Acid; D011239:Prednisolone; D008775:Methylprednisolone