Non-pitting myxedema

Introduction Non-depression mucus edema is a characteristic clinical response to thyroid hormone deficiency in adults. Primary hypothyroidism (hypothyroidism) is the most common type, presumably an autoimmune disease, usually due to Hashimoto's thyroiditis, often accompanied by a solid goiter, and then shrinks as the disease progresses. The fibrous thyroid has no or little function. The second most common type is hypothyroidism after treatment, especially for radioactive iodine and surgical treatment of hyperthyroidism. Propylthiouracil, tazobactam and iodine over-treatment for hypothyroidism, often recovered after termination of treatment. Mild hypothyroidism is common in older women. Most patients with non-Hashimoto goiter have normal thyroid function or hyperthyroidism, but hypothyroidism can occur in patients with endemic goiter. Iodine deficiency reduces thyroid hormone synthesis, TSH release, thyroid enlargement under TSH excitation, iodine absorption increases, and thyroid enlargement. If the iodine is severely deficient, the patient will become hypothyroidism, but since the emergence of iodized salt, the disease has actually been eliminated in the United States. Endemic cretinism is the most common cause of congenital hypothyroidism in iodine-deficient areas and the leading cause of mental disorders worldwide. A rare genetic enzyme deficiency can cause thyroid hormone synthesis disorders and hypothyroidism. Secondary hypothyroidism occurs when there is a lack of TRH secretion in the hypothalamus, hypothalamic pituitary axis failure, or pituitary lack of TSH secretion.

Cause

Thyroid dysfunction can be caused by abnormalities in the thyroid gland itself, pituitary gland, or even hypothalamus. Those associated with the thyroid gland are certain drugs (radioactive iodine, antithyroid agents, lithium, p-aminosalicylic acid), cervical radiation therapy, thyroidectomy, and Hashimoto's thyroiditis.

an examination

Related inspection

Plasma thyroid stimulating hormone releasing hormone (TRH) blood routine

Use your fingers to press the skin (such as the medial malleolus, anterior region or frontal or iliac crest). If there is no depression, it is called non-recessed edema.

The symptoms and signs of primary hypothyroidism are significantly opposite to the formation of hyperthyroidism, and the onset can be concealed and elusive. Facial expression is dull, hoarse, and speech slow; due to the infiltration of vitreous polysaccharides of hyaluronic acid and chondroitin sulfate, the face and periorbital swelling are cold and significant. Due to the lack of adrenal impulses, drooping eyelids, sparse hair, rough and dry, dry skin, rough, scaly flaking and thickening. Moderate weight gain is mainly due to reduced food metabolism and water retention. Patient forgetfulness and display of intelligent impairment with progressive personality changes. Some manifestations of depression, may have obvious mental illness (mucinous edema mania).

Differential diagnosis

Depressed edema: When there is excessive accumulation of body fluid in the subcutaneous tissue space, the skin is pale, swollen, wrinkles become shallow, the local temperature is low, the elasticity is poor, and the part is pressed with a finger (such as the internal hemorrhoids, the anterior region or the front and the iliac crest) Skin, if there is a depression, is called pitting edema or frank edema. After the finger is released, the depression will take a few seconds to resolve. This is due to the depression of edema, there is more free water in the subcutaneous tissue gap, because the local pressure is increased, the free water is moved to the lower pressure, so the depression occurs, and the free water returns to the original position after the finger is released. The time is the time for the depression to recover.

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