Respiratory Failure with Myxedema Ascites in a Patient with Idiopathic Myxedema
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概要
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Here we report the case of a 50-year-old woman presenting with weight gain, whole-body edema, and massive ascites. Blood examination revealed primary hypothyroidism with TSH-blocking antibody, and the echocardiogram showed diffuse hypokinesis of the left ventricle with pericardial effusion. Although she received thyroid hormone replacement therapy immediately, her ascites increased and she developed type II respiratory failure requiring transient noninvasive positive pressure ventilation (NIPPV). She recovered following the temporary drainage of the ascites, administration of diuretics, and continuous thyroid hormone replacement. The amount of ascites decreased during therapy, along with an increase in thyroid hormone levels. Finally, the ascites disappeared completely, followed by the normalization of the cardiac wall motion. Herein we report this rare case in detail, and also discuss the mechanism by which primary hypothyroidism induced such severe conditions in our patient.
著者
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WATANABE Takayuki
Department of Innovative and Engineered Materials, Interdisciplinary Graduate School, Tokyo Institut
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HIRATA YUKIO
Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate Sch
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Gotyo Naoki
Department of Internal Medicine, Yokohama City Minato Red Cross Hospital
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Hiyama Makiyo
Department of Internal Medicine, Yokohama City Minato Red Cross Hospital
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Adachi Junichiro
Department of Internal Medicine, Yokohama City Minato Red Cross Hospital
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Gotyo Naoki
Department Of Endocrinology And Metabolism Tokyo Metropolitan Toshima Hospital
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Hirata Yukio
Department Of Anatomy And Embryology Tokyo Metropolitan Institute For Neurosciences:(present)departm
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Watanabe Takayuki
Department Of Biochemistry School Of Dentistry Hokkaido University
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