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Hyperthyroidism With Non-chylous Ascites: A Case Report

Ascites is the accumulation of fluid in the abdominal cavity and is commonly attributed to various etiologies, including portal hypertension and peritoneal diseases. Hyperthyroidism is rarely associated with ascites, which is typically chylous and accompanied by high central venous pressure. We pres...

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Autores principales: Takahashi, Shodai, Satoh, Kasumi, Okuyama, Manabu, Hirasawa, Nobuhisa, Nakae, Hajime
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628337/
https://www.ncbi.nlm.nih.gov/pubmed/37942363
http://dx.doi.org/10.7759/cureus.46657
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author Takahashi, Shodai
Satoh, Kasumi
Okuyama, Manabu
Hirasawa, Nobuhisa
Nakae, Hajime
author_facet Takahashi, Shodai
Satoh, Kasumi
Okuyama, Manabu
Hirasawa, Nobuhisa
Nakae, Hajime
author_sort Takahashi, Shodai
collection PubMed
description Ascites is the accumulation of fluid in the abdominal cavity and is commonly attributed to various etiologies, including portal hypertension and peritoneal diseases. Hyperthyroidism is rarely associated with ascites, which is typically chylous and accompanied by high central venous pressure. We present a unique case of a 57-year-old woman with untreated hyperthyroidism who manifested non-chylous ascites without evidence of high venous pressure. Initially presenting with left lower leg pain, the patient presented with leg edema, abdominal distention, and diarrhea. A range of diagnostic tests ruled out common etiologies of ascites, such as liver cirrhosis, renal impairment, heart failure, infection, and malignancy. Ascites was characterized by low triglyceride levels, while no evidence of high venous pressure was found. Notably, the patient showed decreased levels of rapid turnover proteins, suggesting hypercatabolism and insufficient protein synthesis due to hyperthyroidism. Upon the initiation of antithyroid therapy, the patient’s symptoms markedly improved. In conclusion, this report highlights a rare manifestation of hyperthyroidism that resulted in non-chylous ascites without high venous pressure. This underscores the need to include hyperthyroidism in the differential diagnosis of unexplained ascites, particularly in cases in which classical hyperthyroid symptoms are absent.
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spelling pubmed-106283372023-11-08 Hyperthyroidism With Non-chylous Ascites: A Case Report Takahashi, Shodai Satoh, Kasumi Okuyama, Manabu Hirasawa, Nobuhisa Nakae, Hajime Cureus Endocrinology/Diabetes/Metabolism Ascites is the accumulation of fluid in the abdominal cavity and is commonly attributed to various etiologies, including portal hypertension and peritoneal diseases. Hyperthyroidism is rarely associated with ascites, which is typically chylous and accompanied by high central venous pressure. We present a unique case of a 57-year-old woman with untreated hyperthyroidism who manifested non-chylous ascites without evidence of high venous pressure. Initially presenting with left lower leg pain, the patient presented with leg edema, abdominal distention, and diarrhea. A range of diagnostic tests ruled out common etiologies of ascites, such as liver cirrhosis, renal impairment, heart failure, infection, and malignancy. Ascites was characterized by low triglyceride levels, while no evidence of high venous pressure was found. Notably, the patient showed decreased levels of rapid turnover proteins, suggesting hypercatabolism and insufficient protein synthesis due to hyperthyroidism. Upon the initiation of antithyroid therapy, the patient’s symptoms markedly improved. In conclusion, this report highlights a rare manifestation of hyperthyroidism that resulted in non-chylous ascites without high venous pressure. This underscores the need to include hyperthyroidism in the differential diagnosis of unexplained ascites, particularly in cases in which classical hyperthyroid symptoms are absent. Cureus 2023-10-07 /pmc/articles/PMC10628337/ /pubmed/37942363 http://dx.doi.org/10.7759/cureus.46657 Text en Copyright © 2023, Takahashi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Endocrinology/Diabetes/Metabolism
Takahashi, Shodai
Satoh, Kasumi
Okuyama, Manabu
Hirasawa, Nobuhisa
Nakae, Hajime
Hyperthyroidism With Non-chylous Ascites: A Case Report
title Hyperthyroidism With Non-chylous Ascites: A Case Report
title_full Hyperthyroidism With Non-chylous Ascites: A Case Report
title_fullStr Hyperthyroidism With Non-chylous Ascites: A Case Report
title_full_unstemmed Hyperthyroidism With Non-chylous Ascites: A Case Report
title_short Hyperthyroidism With Non-chylous Ascites: A Case Report
title_sort hyperthyroidism with non-chylous ascites: a case report
topic Endocrinology/Diabetes/Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628337/
https://www.ncbi.nlm.nih.gov/pubmed/37942363
http://dx.doi.org/10.7759/cureus.46657
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