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Hyperthyroidism With Non-chylous Ascites: A Case Report
Shodai Takahashi1, Kasumi Satoh2, Manabu Okuyama2
1Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, JPN.
Cureus
|November 9, 2023
Summary
This case study reveals a rare instance of hyperthyroidism causing non-chylous ascites without elevated venous pressure. Prompt antithyroid treatment resolved the ascites, highlighting a crucial diagnostic consideration.
Area of Science:
- Endocrinology
- Gastroenterology
Background:
- Ascites, or abdominal fluid accumulation, typically stems from portal hypertension or peritoneal diseases.
- Hyperthyroidism is an uncommon cause of ascites, usually presenting as chylous ascites with high central venous pressure.
Observation:
- A 57-year-old woman with untreated hyperthyroidism developed non-chylous ascites without high venous pressure.
- Initial symptoms included leg edema, abdominal distention, and diarrhea; common ascites causes were excluded.
- Diagnostic findings revealed low triglyceride levels in the ascites and decreased rapid turnover proteins.
Findings:
- The patient's non-chylous ascites was directly linked to hyperthyroidism, not typical causes like cirrhosis or heart failure.
- Hyperthyroidism likely induced ascites through hypercatabolism and impaired protein synthesis, rather than elevated venous pressure.
Implications:
- This case highlights hyperthyroidism as a rare but important differential diagnosis for unexplained ascites.
- Clinicians should consider hyperthyroidism in patients with ascites, especially when classic symptoms are absent or atypical.
