Discussion of Misdiagnosis of Primary Hypothyroidism with Polyserous Effusions as Initial Manifestations

LI Fu-qing; FANG Xing-guo; WANG Hong

doi:10.3969/j.issn.1002-3429.2018.06.009

Abstract：Objective To investigate the clinical characteristics and causes of misdiagnosis of primary hypo-thyroidism with polyserous effusions as initial manifestations. Methods The clinical data of a patient who was ad-mitted to our hospital for primary hypothyroidism with polyserous effusions as initial manifestations was analyzed retro-spectively. Results The patient was hospitalized with abdominal pain and fever for more than one month, and un-derwent various medical examinations, including CT examinations of the chest and abdomen, color doppler ultrasound ( color ultrasound) of the combined heart, urinary system and abdomen as well as gynecological ultrasound, and blood routine examination. The preliminary diagnosis was as follow:(1) Tumor? (2) Tuberculosis (TB)? (3) The connective tissue disease? (4) Other diseases? Anti-tuberculosis treatment was not effective. The anti-nuclear anti-body and anti-nuclear antibody spectrum were negative, therefore, the connective tissue disease was further exclu-ded. After repeated questioning of the medical history and improving thyroid function examination, the diagnosis of hypothyroidism was made. Thus, left thyroxine sodium (25 μg/d) was taken orally, and the patient was discharged home after the condition was improved. During the 6-month follow-up, polyserous effusions were obviously reduced. Conclusion For the elderly patients with polyserous effusion as initial manifestations, it is necessary to be aware of the possibility of hypothyroidism in clinical practice. Heightened awareness and relevant examinations are helpful for early diagnosis and treatment.