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[Ascites due to hypothyroidism]

J A Wegdam1, H M Kooistra, B J Kingma

  • 1St.-Elisabeth Hospitaal, afd. Interne Geneeskunde, Nederlandse Antillen.

Nederlands Tijdschrift Voor Geneeskunde
|April 18, 1998
PubMed
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Hypothyroidism can cause ascites (fluid in the abdomen) with high protein levels. Treating with levothyroxine prevents recurrence, suggesting thyroid hormone replacement is key for managing this specific type of ascites.

Area of Science:

  • Endocrinology
  • Gastroenterology

Background:

  • Ascites, or abdominal fluid accumulation, can have various causes.
  • Hypothyroidism, a condition of underactive thyroid, is an uncommon but potential cause of ascites.

Observation:

  • A 77-year-old male patient presented with ascites attributed to hypothyroidism.
  • The ascites fluid was characterized by high total protein and a high serum-to-ascites albumin gradient (SAAG).

Findings:

  • Ascites remission was achieved through salt restriction, diuretics, and paracentesis.
  • Levothyroxine monotherapy effectively prevented ascites recurrence.
  • Ascites re-emerged upon levothyroxine withdrawal due to non-compliance, reinforcing the link to thyroid status.

Implications:

Related Experiment Videos

  • The pathogenesis of hypothyroid ascites remains unclear, with hypotheses including increased capillary permeability or lymphatic obstruction.
  • Testing for hypothyroidism is recommended for patients with unexplained ascites, particularly those with a high SAAG (> 11 g/l).
  • This case highlights the importance of thyroid hormone replacement in managing ascites related to hypothyroidism.