Thirone Ana Cláudia Pelegrinelli, Danieli Rafael Vinícius, Ribeiro Vanessa Marajó Fernandes Corrêa
Departamento de Endocrinologia e Metabologia, Hospital Universitário, Universidade de Uberaba (Uniube), Uberaba, MG, Brasil.
Arq Bras Endocrinol Metabol. 2012 Aug;56(6):383-7. doi: 10.1590/s0004-27302012000600007.
The aim of this study is to report a rare case of massive pericardial effusion as initial manifestation of hypothyroidism. A previously healthy 21-year-old female patient suddenly began presenting dyspnea at rest and lower limb edema. Routine laboratory tests performed at admission showed hypothyroidism (TSH 146.14 mUI/L) and echocardiography showed significant pericardial effusion. Therapy was instituted with levothyroxine, resulting in clinical improvement without pericardiocentesis. The patient was followed up for 1 year, with total remission of dyspnea and edema. However, she developed typical symptoms of hypothyroidism, and remained with asthenia, dyslipidemia, weight gain, and mild pericardial effusion at the end of one year, even with the optimization of the levothyroxine dose. This case highlights the need for early investigation of hypothyroidism in patients with pericardial effusion.
本研究的目的是报告一例罕见的以大量心包积液为甲状腺功能减退初始表现的病例。一名既往健康的21岁女性患者突然开始出现静息时呼吸困难和下肢水肿。入院时进行的常规实验室检查显示甲状腺功能减退（促甲状腺激素146.14 mUI/L），超声心动图显示大量心包积液。给予左甲状腺素治疗，无需心包穿刺即取得临床改善。对该患者进行了1年的随访，呼吸困难和水肿完全缓解。然而，她出现了典型的甲状腺功能减退症状，即使优化了左甲状腺素剂量，在1年末仍有乏力、血脂异常、体重增加和轻度心包积液。该病例强调了对心包积液患者早期筛查甲状腺功能减退的必要性。
