title: Severe ascites with hypothyroidism and elevated CA125 concentration: a case report.
abstract: Ascites caused by hypothyroidism is rare and the pathogenesis is unclear. Several reports have presented cases of progressive ascites with hypothyroidism and elevated tumor markers. We report a 31-year-old female case with massive ascites and elevated serum CA 125 concentrations. The patient had no typical feature of hypothyroidism except an accumulation of ascitic fluid which showed elevated total protein concentration and a high serum-ascites albumin gradient (SAAG). There was no finding of malignancy. Following thyroid hormone replacement, the ascites was completely resolved accompanied by reduced concentrations of serum CA125. In general, primary hypothyroidism with ascites presents with coexisting massive pericardial or pleural effusion. The massive ascites and increased serum CA125 concentrations may have led us to make the incorrect diagnosis of ovarian malignancy. The evaluation of thyroid function is useful to determine the pathology of high-protein ascites or elevated tumor markers, and ascites may be treatable by thyroid replacement therapy.
authors: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan.
authors: Ryosuke
authors: R
authors: Kimura
authors: Kenro
authors: K
authors: Imaeda
authors: Tatsuo
authors: T
authors: Mizuno
authors: Kazuko
authors: K
authors: Wakami
authors: Kazuhiro
authors: K
authors: Yamada
authors: Naotsuka
authors: N
authors: Okayama
authors: Yoshinobu
authors: Y
authors: Kamiya
authors: Takashi
authors: T
authors: Joh
mesh_terms: D000328:Adult; D001201:Ascites / Q000150:complications* / Q000175:diagnosis*; D018394:CA-125 Antigen / Q000032:analysis*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D018828:Immunoglobulins, Thyroid-Stimulating / Q000032:analysis / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage
chemical_list: D018394:CA-125 Antigen; D018828:Immunoglobulins, Thyroid-Stimulating; C118905:thyroid stimulation-blocking antibody; D013974:Thyroxine