バセドウ病を伴つた限局性粘液水腫の一症例について

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A 54 year old male was admitted to this hospital for Graves's disease complicated with typical localized myxedema on both pretibial regions and dorsal surfaces of the feet. Clinical investigations, including quantitative estimations of mucoprotein, protein-bound mucopolysaccharide and TSH in the blood, furthermore, of biuronic acid in the local tissue, were carried out and the results are summarized as follows : <BR>1. The TSH equivalent value in the plasma measured by Bakke-Ogura's modification was elevated up to nearly 10 times of normal value and the exophthalmic producing test described by Barraqer and Canadell previously was striking positive. The serum mucoprotein, protein-bound polyssaccharide and biuronic acid in the local tissue were all markedly increased. Mercapto-imidazole in daily dose of 30 mg for 3 months could make a marked reduction of the local myxedema in size as well as a remarkable improvement of the general thyrotoxic condition. Furthermore, application of elastic bandages on the lesions after several local injections of hyaluronidase with oral mercapto-imidazole administration induced almost complete disappearance of the local myxedema.<BR>2. The authors, therefore, believe that the exophthlmos and the localized myxedema in this case are caused by a similar pathogenesis, i.e., a marked local accumulation of the strikingly increased acid mucopolysaccharide in the tissues, particularly of hyouronic acid in the retroorbital and pretibial regions, resulting possibly from the longstanding TSH hyper-excretion of the anterior pituitary hormones.
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バセドウ病を伴つた限局性粘液水腫の一症例について

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