Multiple sclerosis co-existent with myxedema. An autopsy case report

Area of Science:

• Neurology
• Endocrinology
• Pathology

Background:

• This study presents a unique case of a 64-year-old woman with a complex interplay of neurological and endocrine symptoms.
• The patient exhibited progressive neurological deficits and signs suggestive of hormonal imbalance, with seasonal symptom exacerbations.

Observation:

• The patient presented with impaired consciousness, vision loss, sensorimotor paresis, hypothermia, bradycardia, and edema.
• Laboratory findings included high cerebrospinal fluid (CSF) protein and low serum thyroxine (T4) and thyroid-stimulating hormone (TSH) levels.
• Postmortem examination revealed significant atrophy of the pituitary and thyroid glands and demyelinating plaques in the central nervous system.

Findings:

• The case demonstrates the co-existence of pituitary and thyroid gland atrophy with multiple demyelinating lesions.
• Treatment with prednisolone and thyroxine showed transient improvement in consciousness and edema.
• The patient ultimately succumbed to pulmonary embolism.

Implications:

• This report is the first to document the simultaneous occurrence of these two distinct pathological conditions.
• Understanding this rare combination is crucial for diagnosing and managing complex neuroendocrine disorders.
• Further research may elucidate the potential pathogenic links between autoimmune processes affecting the pituitary, thyroid, and central nervous system.