Facial edema associated with thyroid autoimmunity.
BACKGROUND
There is growing evidence that some cases of chronic urticaria and angioedema are associated with thyroid autoimmunity. We present the case of a 42-year old woman with a two month long evolution of edema in the right hemiface associated with thyroid antibodies.


METHODS
Skin tests were performed with a standard series of aeroallergens and foods and were negative. Epicutaneous tests were performed with a series of contact allergens with a negative result. The chest X-ray was normal. A complete blood count was performed with ESR, biochemistry study, proteinogram, coagulation, complement, rheumatoid factor, anti-nuclear antibodies, hydatidosis and hepatitis serologies, urine sediment and stool parasitology, which were normal. The TSH was normal and, among the thyroid antibodies, the thyroglobulin ones (492 IU/mL) were positive and the microsomal ones were negative.


RESULTS
The edema remitted with the 2-month long thyroxin treatment. In spite of the clinical response, and although the thyroglobulin antibodies initially suffered a small decrease, they increased to values which greatly surpassed the initial ones, coinciding with a relapse of the facial edema, so that treatment was re-initiated with thyroxin, and the picture subsided again.


CONCLUSIONS
Some cases of localized edema can be associated with thyroid antibodies and respond to treatment with thyroxin.
Miralles
J C
JC
Allergy Section. University General Hospital of Murcia. Spain.
Soriano
J
J
Negro
J M
JM
D000328:Adult; D004487:Edema / Q000209:etiology*; D005145:Face; D005260:Female; D006801:Humans; D012882:Skin Tests; D013954:Thyroglobulin / Q000032:analysis; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000188:drug therapy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use; D014284:Triiodothyronine / Q000097:blood
D014284:Triiodothyronine; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine