Takahashi Nobuyuki, Shimada Toshio, Ishibashi Yutaka, Oyake Nobuyuki, Murakami Yo
Division of Cardiovascular Medicine, Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo City, Japan.
Am J Med Sci. 2007 Jun;333(6):387-9. doi: 10.1097/MAJ.0b013e318065b023.
We report a case of a 66-year-old woman admitted to our hospital for examination and treatment of uterine and rectal prolapse, pleural and pericardial effusion, and ascites. On further examination, she was diagnosed with hypothyroidism. Test results showed markedly elevated concentrations of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA 125). We consequently performed multiple imaging studies, none of which detected a malignancy. Hormonal replacement therapy with levothyroxine was started, and the pleural and pericardial effusion and ascites gradually abated. Concentrations of serum CEA and CA125 also decreased gradually after therapy with levothyroxine. These findings indicate that in patients with hypothyroidism, elevated CEA and CA125 levels do not necessarily indicate malignancy. Conversely, in any patient with elevated serum CEA and/or CA125, hypothyroidism should be considered in the differential diagnosis.
我们报告一例66岁女性患者，因子宫和直肠脱垂、胸腔和心包积液以及腹水入院接受检查和治疗。进一步检查发现，她被诊断为甲状腺功能减退症。检测结果显示血清癌胚抗原（CEA）和糖类抗原125（CA 125）浓度显著升高。因此，我们进行了多项影像学检查，但均未发现恶性肿瘤。开始使用左甲状腺素进行激素替代治疗后，胸腔和心包积液以及腹水逐渐消退。左甲状腺素治疗后，血清CEA和CA125浓度也逐渐下降。这些发现表明，在甲状腺功能减退症患者中，CEA和CA125水平升高不一定表明存在恶性肿瘤。相反，在任何血清CEA和/或CA125升高的患者中，鉴别诊断时应考虑甲状腺功能减退症。
