Some lessons from a rare case of severe elephantiasic myxedema associated with subclinical thyroid disease

dc.creatorWard, LS
dc.creatorFacuri, FD
dc.creatorCintra, ML
dc.creatorCia, EMM
dc.date2006
dc.dateSEP-OCT
dc.date2014-11-19T03:09:49Z
dc.date2015-11-26T17:56:38Z
dc.date2014-11-19T03:09:49Z
dc.date2015-11-26T17:56:38Z
dc.date.accessioned2018-03-29T00:40:15Z
dc.date.available2018-03-29T00:40:15Z
dc.identifierEndocrinologist. Lippincott Williams & Wilkins, v. 16, n. 5, n. 245, n. 247, 2006.
dc.identifier1051-2144
dc.identifierWOS:000241201500003
dc.identifier10.1097/01.ten.0000240935.91711.c6
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/71909
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/71909
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/71909
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1291296
dc.descriptionBecause grotesque swelling of lower and upper extremities occurs in less than 3% of patients with myxedema, it has been proposed that the development of this rare dermopathy requires both severity and a long duration of active autoinumme disease. It is speculated that the deposition of mucopolysaccharides causes clinical manifestations in areas exposed to trauma or mechanical factors. We report a case of severe elephantiasic myxedema in a 68-year-old black man that remained undiagnosed for 3 years. His first symptoms were hard swelling of feet and the pretibial areas that then spread to his hands and forearms causing marked impairment of movement. Physical examination revealed bilateral breast enlargement, periorbital edema, and proptosis. Skin biopsies showed large deposits of mucin in the superficial and medium dermis of the legs and breast. Thyroid function tests revealed a suppressed thyroid-stimulating hormone of 0.04 mU/L with normal free T4,1.46 ng/dL, that remained unchanged for 4 months. Antithyroid-stimulating hormone receptor antibodies were markedly positive: thyrotropinreceptor antibody, 520 U/L (positive > 15). The patient lost 15 kg over the next 8 months without treatment, and armodarone was then introduced because of increasing cardiac arrhythmias. This led to overt hypothyroidism (thyroid-stimulating hormone, 15.3 mU/L). The development of severe elephantiasic myxedema during the subclinical phase of the autoimmune thyroid disease suggests that high levels of thyrotropin-receptor antibody are important in the genesis of glycosaminoglycan production and accumulation.
dc.description16
dc.description5
dc.description245
dc.description247
dc.languageen
dc.publisherLippincott Williams & Wilkins
dc.publisherPhiladelphia
dc.publisherEUA
dc.relationEndocrinologist
dc.relationEndocrinologist
dc.rightsfechado
dc.sourceWeb of Science
dc.subjectsubclinical hypothyroidism
dc.subjectsubclinical hyperthyroidism
dc.subjectdermopathy
dc.subjectpseudogynecomastia
dc.subjectPretibial Myxedema
dc.subjectGraves-disease
dc.subjectOphthalmopathy
dc.subjectManifestations
dc.subjectPathogenesis
dc.subjectFibroblasts
dc.subjectDermopathy
dc.subjectCoculture
dc.subjectCells
dc.titleSome lessons from a rare case of severe elephantiasic myxedema associated with subclinical thyroid disease
dc.typeArtículos de revistas


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