Subclinical hypothyroidism unmasked by preeclampsia and ascites

Subclinical hypothyroidism is an asymptomatic endocrine disorder while hypothyroidism, on the other hand, can present with a wide range of clinical features which may be nonspecific. We describe a case of subclinical hypothyroidism in a 39-year-old pregnant woman presenting with preeclampsia and ascites. Ascitic fluid was found to be exudative as typically found in persons with hypothyroidism presenting with ascites. Treatment with levothyroxine resulted in complete resolution of ascites. The possibility of subclinical and clinical hypothyroidism should be borne in mind when persons with refractory exudative ascites of unknown origin are being investigated. Also, pregnant women with severe preeclampsia will benefit from screening for subclinical and clinical hypothyroidism.