Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Graves’ hyperthyroidism has a number of well-recognized but relatively rare extrathyroid manifestations such as thyroid acropachy, pretibial myxedema, and congestive heart failure.</p> <p>Case presentation</p> <...

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Main Authors: Volke Vallo, Matjus Svetlana
Format: Article
Language:English
Published: BMC 2012-08-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:http://www.jmedicalcasereports.com/content/6/1/258
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author Volke Vallo
Matjus Svetlana
author_facet Volke Vallo
Matjus Svetlana
author_sort Volke Vallo
collection DOAJ
description <p>Abstract</p> <p>Introduction</p> <p>Graves’ hyperthyroidism has a number of well-recognized but relatively rare extrathyroid manifestations such as thyroid acropachy, pretibial myxedema, and congestive heart failure.</p> <p>Case presentation</p> <p>A 38-year-old Caucasian woman presented to the out-patient clinic with symptoms of hyperthyroidism lasting for approximately five months. Remarkably, she had developed pitting edema of her left leg four months before. She had gone through a conventional assessment, but the reason for the edema was not revealed. At presentation to the endocrinology clinic, the skin of both legs was of normal color and pitting edema on her left leg was of a diffuse nature and spread from her toes to two thirds of her leg. The skin surface of her left leg was smooth and had no elevations or discoloration, whereas her right leg appeared normal. Based on signs and symptoms of thyrotoxicosis and suppressed thyroid-stimulating hormone level (less than 0.001mIU/L, local reference of 0.4 to 4), treatment of 10mg of thiamazole three times a day was started. Additional blood tests revealed marked Graves’ hyperthyroidism with elevated free T4 and anti-thyroid receptor antibodies. Within a month, the free T4 level was normalized and the edema was completely cleared and never reappeared during the treatment course of 12 months.</p> <p>Conclusions</p> <p>To the best of our knowledge, this is the first description of unilateral treatment-responsive leg edema as a manifestation of Graves’ hyperthyroidism. However, the pathophysiological mechanism underlying this case of edema remains unclear.</p>
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spelling doaj.art-ce3615b229fe4540aa2d0d3b561f45612022-12-22T01:00:25ZengBMCJournal of Medical Case Reports1752-19472012-08-016125810.1186/1752-1947-6-258Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case reportVolke ValloMatjus Svetlana<p>Abstract</p> <p>Introduction</p> <p>Graves’ hyperthyroidism has a number of well-recognized but relatively rare extrathyroid manifestations such as thyroid acropachy, pretibial myxedema, and congestive heart failure.</p> <p>Case presentation</p> <p>A 38-year-old Caucasian woman presented to the out-patient clinic with symptoms of hyperthyroidism lasting for approximately five months. Remarkably, she had developed pitting edema of her left leg four months before. She had gone through a conventional assessment, but the reason for the edema was not revealed. At presentation to the endocrinology clinic, the skin of both legs was of normal color and pitting edema on her left leg was of a diffuse nature and spread from her toes to two thirds of her leg. The skin surface of her left leg was smooth and had no elevations or discoloration, whereas her right leg appeared normal. Based on signs and symptoms of thyrotoxicosis and suppressed thyroid-stimulating hormone level (less than 0.001mIU/L, local reference of 0.4 to 4), treatment of 10mg of thiamazole three times a day was started. Additional blood tests revealed marked Graves’ hyperthyroidism with elevated free T4 and anti-thyroid receptor antibodies. Within a month, the free T4 level was normalized and the edema was completely cleared and never reappeared during the treatment course of 12 months.</p> <p>Conclusions</p> <p>To the best of our knowledge, this is the first description of unilateral treatment-responsive leg edema as a manifestation of Graves’ hyperthyroidism. However, the pathophysiological mechanism underlying this case of edema remains unclear.</p>http://www.jmedicalcasereports.com/content/6/1/258Graves’ diseaseHyperthyroidismEdema
spellingShingle Volke Vallo
Matjus Svetlana
Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report
Journal of Medical Case Reports
Graves’ disease
Hyperthyroidism
Edema
title Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report
title_full Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report
title_fullStr Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report
title_full_unstemmed Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report
title_short Unilateral pitting edema of the leg as a manifestation of Graves’ disease: a case report
title_sort unilateral pitting edema of the leg as a manifestation of graves disease a case report
topic Graves’ disease
Hyperthyroidism
Edema
url http://www.jmedicalcasereports.com/content/6/1/258
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