Kind R, Hornstein O P
Hautarzt. 1976 Aug;27(8):375-81.
We have reported on two cases of pretibial myxedema. In one patient, the pretibial myxedema developed symmetrically half a year after the appearance of endocrine exophthalmos. Recently, acropachy developed as well. In the second case, the pretibial myxedema arose unilaterally in an old cicatricial area, six years after the onset of endocrine exophthalmos. In this syndrome, the development of the whole group of symptoms, dermopathy, ophthalmopathy, and osteopathy at the same time is very rare. The clinical picture is seen in thyroid disorders, as a rule occuring in hyperthyroidism, rarely in hypothyroid or euthyroid states. Apparently, the development of the symptoms does not depend on thyroid hormone production. One of our patients showed conspicuous hyperthyroidism, the other, thyroxin deficiency. The thyreohypophyseal feedback mechanism in this syndrome was examined for the first time by means of TRH stimulation tests. In both patients, thyroid auto-antibodies indicative of autoimmune thyroiditis were demonstrated. A high activity of long acting thyroid stimulator was measured in the one patient's serum.
我们报告了两例胫前黏液性水肿的病例。在一名患者中，胫前黏液性水肿在内分泌性突眼出现半年后对称发生。最近，还出现了杵状指。在第二例中，胫前黏液性水肿单侧出现在一个陈旧的瘢痕区域，在内分泌性突眼发病六年之后。在这种综合征中，同时出现整个症状群，即皮肤病变、眼病和骨病的情况非常罕见。这种临床症状常见于甲状腺疾病，通常发生在甲状腺功能亢进症中，很少见于甲状腺功能减退或甲状腺功能正常的状态。显然，症状的发展并不取决于甲状腺激素的产生。我们的一名患者表现出明显的甲状腺功能亢进，另一名患者则表现为甲状腺素缺乏。首次通过促甲状腺激素释放激素（TRH）刺激试验对该综合征中的甲状腺垂体反馈机制进行了检查。在两名患者中，均检测到了提示自身免疫性甲状腺炎的甲状腺自身抗体。在一名患者的血清中检测到长效甲状腺刺激素的高活性。
