Severe hypothyroidism associated with the degree of edema in a patient with nephrosis

  • Hiroyuki Kinoshita | hkinoshita-tky@umin.ac.jp Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Amiko Ishii Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Akiko Hayakawa Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Mutsuko Yasuda Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Seiji Inoshita Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Fumiatsu Yakushiji Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.

Abstract

We report the pleural fluid values of thyroid hormones and their carrier proteins in a patient who suffered from nephrotic syndrome with renal insufficiency and transient hypothyroidism. The pleural effusion was transudate. The concentrations of thyroxine-binding globulin (TBG), thyroxine-binding prealbumin (TBPA), and albumin (Alb) were approximately 30-50% of the plasma. The concentrations of total triiodothyronine (TT3), total tetraiodothyronine (TT4), free triiodothyronine (FT3), and free tetraiodothyronine (FT4) were approximately 30-50% of the plasma. Hypothyroidism was associated with the degree of edema. After improving systemic edema, proteinuria remained unchanged but the patient did not require levothyroxine. We speculate that the large amount of transudation of thyroid hormones with their carrier proteins from the blood vessels to the third space (edema and pleural effusion), thereby reducing thyroid hormones in the plasma, was associated with hypothyroidism.

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Published
2011-10-13
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Section
Case Reports
Keywords:
thyroid hormones, thyroid hormonebinding proteins, hypothyroidism, pleural effusion, edema, nephrotic syndrome.
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How to Cite
Kinoshita, H., Ishii, A., Hayakawa, A., Yasuda, M., Inoshita, S., & Yakushiji, F. (2011). Severe hypothyroidism associated with the degree of edema in a patient with nephrosis. Clinics and Practice, 1(3), e78. https://doi.org/10.4081/cp.2011.e78