[Dysphagia as a symptom of myxedema]

We present a 79 year old female patient with dysphagia since two years. She showed also a lack of initiation and dysphonia. In the region of the larynx an edema was found and the tongue was hypertrophied. The X-ray examination demonstrated a dilated esophagus without impairment of the passage way. Esophagoscopy showed also important edema in the hypopharynx and the entry into the esophagus. The TSH-0 was 74.45 mmu/l, the T3 0.23 and the T4 was 24 nmol/l. Scintigraphically an only cherry-stone small region with active thyroid tissue was revealed. Severe hypothyroidism responsible for secondary dysphagia was diagnosed. L-Thyroxin was administered (150 micrograms/d). There was a dramatical improvement. The signs of edema and the dysphagia decreased. The examination a half year later demonstrated a patient without any dysphagia or edema. The symptom dysphagia is defined and an interdisciplinary approach emphasized.