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R R da Cunha Filho, H L de Almeida, J D Basei, R H Camina, L A S de Castro
Pretibial myxedema (PTM) results from the accumulation of hyaluronic acid in the dermis and subcutis and is commonly associated with Graves' disease (GD). It occurs in up to 5% of patients with GD and in 13% of patients with GD and ophthalmopathy. PTM occasionally occurs in thyrotoxicosis but is much less frequently in patients with Hashimoto thyroiditis, primary hypothyroidism and euthyroidism. This article is protected by copyright. All rights reserved.
October 12, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Changgui Lan, Yi Wang, Xia Zeng, Jing Zhao, Xiaoxi Zou
Background. Pretibial myxedema (PTM) is a rare dermopathy. The morphologic features and mechanism of its evolving process are not reported in large case series. Methods. 216 cases with PTM were retrospectively reviewed to analyze demographics, history, lesional morphology and its evolving process, histopathology and immunohistochemistry, serum TRAb levels, treatment, and outcome. Results. First appearing lesions evolved into 6 variants that were correlated with serum TRAb levels. Subvariants were caused by different kinds and frequencies of local trauma...
2016: Journal of Thyroid Research
Michael D Thompson, Rohan K Henry
BACKGROUND: Myxedema coma (MC), a medical emergency defined as severe hypothyroidism leading to altered mental status, is more common in older women with hypothyroidism. METHODS/RESULTS: A 7-year-old Caucasian male with chromosome 1q deletion presented with altered mental status preceded by milestone regression. His presenting labs results were: thyroid-stimulating hormone (TSH) 0.501 μIU/ml and free thyroxine (T4) <0.5 ng/dl. His morning cortisol level was 8...
September 16, 2016: Hormone Research in Pædiatrics
Angela M Leung
Myxedema coma and thyroid storm are thyroid emergencies associated with increased mortality. Prompt recognition of these states-which represent the severe, life-threatening conditions of extremely reduced or elevated circulating thyroid hormone concentrations, respectively-is necessary to initiate treatment. Management of myxedema coma and thyroid storm requires both medical and supportive therapies and should be treated in an intensive care unit setting.
September 2016: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Sébastien Menzinger, Aysin Kaya, Jean-Hilaire Saurat, Gürkan Kaya
BACKGROUND: Hyaluronidases are essential for the breakdown of hyaluronate (HA) in tissues and may be used to prevent the adverse effects of HA fillers. OBJECTIVES: We explored the effect of hyaluronidase on exogenous and endogenous HA in vitro and in vivo. MATERIALS AND METHODS: HA fillers were incubated with different concentrations of hyaluronidase and visualized by electrophoresis. HA fillers were injected in the skin of hairless mice, and 4 h later hyaluronidase was injected in the papules of exogenous HA...
July 2016: Dermatopathology (Basel, Switzerland)
George Liamis, Theodosios D Filippatos, Angelos Liontos, Moses S Elisaf
BACKGROUND: Patients with moderate to severe hypothyroidism and mainly patients with myxedema may exhibit reduced sodium levels (<135 mmol/L). SUMMARY: Aim of the short review is the presentation of the mechanisms of hyponatremia and of the available data regarding its implications and treatment in patients with hypothyroidism. Hypothyroidism is one of the causes of hyponatremia and thyroid-stimulating hormone determination is mandatory during the evaluation of patients with reduced serum sodium levels...
August 2, 2016: European Journal of Endocrinology
M Nazou, E Parlapani, E-I Nazlidou, P Athanasis, V P Bozikas
Thyroid hormones are crucial in adult brain metabolic activity. As a result, abnormal thyroid gland function and in particular hypofunction, might cause principally depression and neurocognitive dysfunction. Psychosis, presented mainly with thought disorders and perceptual disturbances, is a much rarer manifestation of hypothyreoidism. A correlation between hypothyreoidism and psychosis has been described since 1888, especially in cases of advanced hypothyreoidism. A few years later (1949), Asher first added the terminology "myxedema madness" to the literature...
April 2016: Psychiatrikē, Psychiatriki
David P Reardon, Peter S Yoo
Treatment of hypothyroidism with levothyroxine sodium often requires multiple dose adjustments and can be complicated by patients with gastric and intestinal dysfunction that limits absorption. In these cases, doses are often titrated higher than commonly used in clinical practice. Multiple formulations of levothyroxine are currently available and some may be preferred in cases of malabsorption. We report a case of a 42-year-old female who presented with a living unrelated kidney transplant evaluation with myxedema while being treated with levothyroxine sodium tablets...
2016: Case Reports in Endocrinology
Vadim Meytes, Steven P Schulberg, Nicholas Morin, Galina Glinik
The incidence of hypothyroidism presenting with sigmoid volvulus, a phenomenon known as myxedema pseudovolvulus, is exceedingly rare. A male in his late thirties presented to our institution with a chief complaint of abdominal pain. The patient underwent CT scan, which was consistent with massive colonic dilatation with sigmoid volvulus. He was taken to the operating room for exploration and was found to have sigmoid volvulus and underwent a segmental resection. Postoperatively, the patient was newly diagnosed with severe hypothyroidism...
2016: Journal of Surgical Case Reports
Jeremy M Root, Marcela Vargas, Luigi R Garibaldi, Richard A Saladino
Childhood cases of myxedema coma are extremely rare. We report a case of a 5-year-old girl transferred to a tertiary care pediatric emergency department with hypoxemia and altered mental status and diagnosed with severe hypothyroidism and myxedema coma in the setting of acute influenza infection. Although it is rare, myxedema coma must remain in the differential diagnosis for altered mental status and organ dysfunction in the pediatric population.
April 5, 2016: Pediatric Emergency Care
Yosuke Ono, Masanori Fujita, Sachiko Ono, Sho Ogata, Shoichi Tachibana, Yuji Tanaka
Myxedema coma (MC) is a life-threatening endocrine crisis caused by severe hypothyroidism. However, validated diagnostic criteria and treatment guidelines for MC have not been established owing to its rarity. Therefore, a valid animal model is required to investigate the pathologic and therapeutic aspects of MC. The aim of the present study was to establish an animal model of MC induced by total thyroidectomy. We utilized 14 male New Zealand White rabbits anesthetized via intramuscular ketamine and xylazine administration...
June 30, 2016: Endocrine Journal
Paul W Ladenson
The broad spectrum of thyroid disease severity--from subclinical hypothyroidism to myxedema coma, subclinical thyrotoxicosis to thyroid storm, and microscopic papillary to anaplastic cancers--has always demanded that clinicians individualize their management of thyroid patients. Deepening knowledge of thyroid pathophysiology along with advances in diagnostic, prognostic, and therapeutic technologies applicable to thyroid diseases position this field to ride the wave of precision medicine in the decade ahead...
March 2016: Journal of Clinical Endocrinology and Metabolism
Alexandra Frogoudaki, Andreas S Triantafyllis, Evangeline Vassilatou, Charalampos Tsamakis, Achilles Zacharoulis, John Lekakis
INTRODUCTION: Pulmonary hypertension is common among patients with hyperthyroidism, and Graves' disease constitutes the most common cause of thyrotoxicosis. CASE PRESENTATION: We report the case of a female patient admitted to the cardiology department with shortness of breath and pretibial myxedema. The diagnostic work-up revealed combined pre- and post-capillary pulmonary hypertension due to Graves' disease superimposed on left ventricular diastolic dysfunction...
February 2016: Research in Cardiovascular Medicine
Nickolas T Agathis, Ingrid M Libman, Michael L Moritz
Hyponatremia has been reported in the elderly with hypothyroidism and myxedema, but this has not been a universal finding in clinical studies and there have been only a few reports in children. We report a case of an infant who developed hyponatremia due to severe primary hypothyroidism. A 4-month-old ex-preterm male, who had been euthyroid on the newborn screen, developed unexplained hospital-acquired hyponatremia (serum Na 124 mEq/L) while on full oral feeds. He was euvolemic, appeared well and was without myxedema...
2015: Frontiers in Pediatrics
Kajohn Rojanametin, Tanaka Masaru
No abstract text is available yet for this article.
December 2015: Journal of the American Academy of Dermatology
Aisha Hines, Jonathan T Stewart, Glenn Catalano
Hypothyroidism is commonly associated with a variety of psychiatric conditions, most commonly depression and cognitive impairment, but up to 5% to 15% of symptomatically hypothyroid patients may develop a nonaffective psychosis, classically referred to as "myxedema madness." We report the case of a woman who developed Capgras syndrome in the context of hypothyroidism, and whose psychosis rapidly resolved with levothyroxine supplementation. To date, very few cases of Capgras syndrome related to hypothyroidism have been reported...
November 2015: Journal of Psychiatric Practice
Changgui Lan, Can Li, Wei Chen, Xiaofeng Mei, Jing Zhao, Jie Hu
BACKGROUND: Pretibial myxedema (PTM) is an uncommon dermopathy associated with autoimmune thyroid diseases. Now it is thought to be autoimmune and its treatment with glucocorticoid is helpful. However, it has not been evaluated. METHODS: A prospective randomized controlled trial was performed in 110 patients with PTM to evaluate the efficacy and safety of triamcinolone acetonide with intralesional injection once every 3 days and once every 7 days. Randomization was performed with drawing lots and it was also stratified according to variants of PTM lesions...
November 2015: Journal of Clinical Medicine Research
Yanina J Morosán Allo, Melanie Rosmarin, Agustina Urrutia, Maria Cristina Faingold, Carla Musso, Gabriela Brenta
Although hypothyroidism is associated with an increased prevalence of psychiatric manifestations, myxedema madness is rarely observed. We report the case of a 62-year-old woman with no prior history of psychiatric disorders, who presented to the emergency department with psychomotor agitation 6 weeks after total thyroidectomy for papillary thyroid cancer. Serum thyroid stimulating hormone (TSH) on admission was 62.9 mIU/L and free T4 was < 0.35 ng/dL, indicating severe hypothyroidism. After ruling out other possible causes, the diagnosis of myxedema madness was considered; hence, antipsychotic drug treatment and intravenous levothyroxine were prescribed...
August 2015: Archives of Endocrinology and Metabolism
Luana Oliveira Ramos, Paloma Corrêa Mattos, Giuseppe Lemos Pertoti de Figueredo, Alef Alioscha Andrade Maia, Sandra Adolfina Reys Romero
The pretibial myxedema is a manifestation of Graves' disease characterized by accumulation of glycosaminoglycans in the reticular dermis. The dermopathy is self-limiting but in some cases may cause cosmetic and functional damage. Conventional treatment is use of topical steroids under occlusive dressing, however the intralesional application has shown good results. We present a case of pretibial myxedema treated with single injection of intralesional corticosteroid.
May 2015: Anais Brasileiros de Dermatologia
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