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Massive Exudative Pleural Effusion With Hypothyroidism: A Case Report
Yukiko Uehara1, Noriko Ogawa1, Takuma Yamoto1
1Endocrinology and Metabolism, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus
|April 17, 2025
Summary
Hypothyroidism can cause severe fluid buildup, including pleural effusion. Thyroid hormone replacement therapy effectively treated effusions, though drainage was needed for severe cases.
Area of Science:
- Endocrinology
- Cardiology
- Oncology
Background:
- A 79-year-old woman with hypopharyngeal cancer underwent thyroid and parathyroidectomy.
- Post-surgery, she received levothyroxine, calcium, and alfacalcidol.
- She discontinued medications and missed appointments for four months.
Observation:
- The patient developed massive exudative pleural effusion, pericardial effusion, and ascites.
- These conditions were secondary to severe hypothyroidism.
- Prolonged hypothyroidism and potential heart failure may have exacerbated the pleural effusion.
Findings:
- Thyroid hormone replacement therapy resolved pericardial effusion and ascites.
- Pleural effusion improved with drainage and did not recur after hormone replacement.
- Fluid retention due to hypothyroidism typically responds to thyroid hormone therapy.
Implications:
- Severe exudative effusions in hypothyroidism may necessitate drainage when diuretics are ineffective.
- Prompt diagnosis and management of hypothyroidism are crucial for fluid balance.
- This case highlights the systemic effects of thyroid hormone deficiency and the importance of medication adherence.
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