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首页> 外文期刊>Endocrine journal >A Case of Subclinical Hypothyroidism Developing Marked Pleural Effusions and Peripheral Edema with Elevated Vascular Endothelial Growth Factor
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A Case of Subclinical Hypothyroidism Developing Marked Pleural Effusions and Peripheral Edema with Elevated Vascular Endothelial Growth Factor

机译：亚临床甲状腺功能减退症伴明显的胸腔积液和周围水肿伴血管内皮生长因子升高的一例

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A 69-year-old woman was admitted for the treatment of marked pleural effusions and peripheral edema. Analytical studies of the pleural effusion revealed exudates. Culture for bacterial organisms and tuberculosis were negative, and cytology was normal. She had a mediastinal tumor at the age of 61 and regular follow-up showed no evidence of malignancy. She underwent the mediastinal tumor resection, because we thought this was the cause of her symptoms. However, her clinical symptoms persisted after surgery. Next, we noticed subclinical hypothyroidism, in which serum TSH level was elevated with concomitant normal thyroid hormone levels. In addition, serum vascular endothelial growth factor (VEGF) levels, which have been reported to be related to the pathophysiology of the extravascular volume overload, were elevated. Although her TSH level was slightly elevated (15.4 μU/ml), we started thyroid hormone replacement therapy. This therapy gradually ameliorated her clinical manifestation and abnormal laboratory data, including elevated VEGF levels. These observations indicate that even subclinical hypothyroidism may cause severe clinical manifestations. Furthermore, elevated VEGF may be a contributing factor in the pathogenesis of extravascular volume overload in hypothyroid patients.
机译：一名69岁的妇女因明显的胸腔积液和周围性水肿而入院。对胸腔积液的分析研究显示渗出液。细菌和结核的培养阴性，细胞学检查正常。她在61岁时患有纵隔肿瘤，定期随访未发现恶性肿瘤的迹象。她接受了纵隔肿瘤切除术，因为我们认为这是她症状的原因。但是，她的临床症状在手术后仍然持续。接下来，我们注意到亚临床甲状腺功能减退症，其中血清TSH水平升高，同时甲状腺激素水平正常。另外，据报道与血管外容量超负荷的病理生理学有关的血清血管内皮生长因子（VEGF）水平升高。尽管她的TSH水平略有升高（15.4μU/ ml），我们还是开始了甲状腺激素替代疗法。这种疗法逐渐改善了她的临床表现和异常的实验室数据，包括升高的VEGF水平。这些观察结果表明，即使是亚临床甲状腺功能减退症也可能引起严重的临床表现。此外，VEGF升高可能是甲状腺功能减退患者血管外容量超负荷的发病机理中的一个促成因素。

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