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Myxedema ascites in the posttransplant setting: case report
Colleen H McDonough1, Linda Lee, S Jan de Beur
1Department of Oncology, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA. mcdonco@jhmi.edu
American Journal of Hematology
|November 1, 2002
Summary
Hypothyroidism can cause ascites, a rare complication. Prompt diagnosis and thyroid hormone replacement therapy lead to rapid resolution of ascites in patients, including those post-bone marrow transplant.
Area of Science:
- Endocrinology
- Hematology
- Transplant Medicine
Background:
- Ascites is an uncommon complication of hypothyroidism.
- Hypothyroidism diagnosis can be delayed due to nonspecific symptoms.
- Allogeneic bone marrow transplant (BMT) patients face unique post-transplant complications.
Observation:
- A 52-year-old male presented with ascites four months after allogeneic BMT.
- Initial differential diagnoses included common post-BMT complications like hepatic veno-occlusive disease, graft vs. host disease, and infection.
- The patient's ascites was ultimately attributed to hypothyroidism.
Findings:
- Thyroid replacement hormone therapy resulted in rapid and complete resolution of ascites.
- This case highlights that hypothyroidism can occur independently of the transplant procedure.
- Hypothyroidism should be considered in the differential diagnosis of post-BMT patients with atypical presentations.
Implications:
- Broadening the differential diagnosis in post-BMT patients is crucial for accurate diagnosis.
- Early identification and treatment of hypothyroidism can prevent prolonged morbidity.
- This case underscores the importance of considering non-transplant-related conditions in complex patient populations.