Coexistence of Myxedema Ascites and Tuberculous Peritonitis: a Case Report and Literature Review.
10.3904/kjm.2016.91.2.179
- Author:
Doo Hyuck LEE
1
;
Kyong Wook KUK
;
Suk Bae KIM
;
Won Sang YOO
Author Information
1. Department of Internal medicine, Dankook University Medical College, Cheonan, Korea. smff03@hanmail.net
- Publication Type:Case Report
- Keywords:
Ascites;
Hypothyroidism;
Myxedema;
Peritonitis, Tuberculous
- MeSH:
Ascites*;
Ascitic Fluid;
Communicable Diseases;
Diagnosis;
Drug Therapy;
Edema;
Female;
Humans;
Hypothyroidism;
Laparoscopy;
Liver Diseases;
Middle Aged;
Myxedema*;
Peritonitis, Tuberculous*;
Rare Diseases;
Thyroid Function Tests
- From:Korean Journal of Medicine
2016;91(2):179-184
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Some patients have ascites without having liver disease, so it is important to analyze the cause of these ascites. Tuberculous peritonitis is an infectious disease characterized by lymphocyte-dominant exudative ascites. In contrast, myxedema ascites is a very rare disease characterized by a high serum/ascites albumin gradient (SAAG) with hypothyroidism. We herein report a case involving a 48-year-old woman with both diseases simultaneously. She was hospitalized because of massive ascites, generalized edema, and a puffy face. Hypothyroidism was confirmed by thyroid function tests. Her ascitic fluid had a high SAAG; no other specific findings were identified by cytology, culture, or computed tomography. Three months after initiating drug therapy for the hypothyroidism, the patient's systemic edema improved but the ascites recurred. Accordingly, diagnostic laparoscopy was performed, and tuberculous peritonitis was confirmed. As seen in this case, when myxedema ascites is associated with tuberculous peritonitis, an accurate diagnosis may be challenging.
