Difference between revisions of "Myxedema"

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<p><strong>Myxedema</strong> (British English: <strong>myxoedema</strong>) is a skin and tissue disorder usually due to severe prolonged <strong><a title="Hypothyroidism" href="http://en.wikipedia.org/wiki/Hypothyroidism">hypothyroidism</a></strong>. Hypothyroidism can be caused by <a title="Hashimoto's thyroiditis" href="http://en.wikipedia.org/wiki/Hashimoto%27s_thyroiditis">Hashimoto's thyroiditis</a>, surgical removal of the <a title="Thyroid" href="http://en.wikipedia.org/wiki/Thyroid">thyroid</a>, and rarer conditions. Partial forms of myxedema, especially of the lower legs (called <a title="Pretibial myxedema" href="http://en.wikipedia.org/wiki/Pretibial_myxedema">pretibial myxedema</a>), occasionally occur in adults with <a title="Graves' disease" href="http://en.wikipedia.org/wiki/Graves%27_disease">Graves' disease</a>, a cause of hyperthyroidism; or also Hashimoto's thyroiditis without severe hypothyroidism.</p>
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                <li class="toclevel-1"><a href="http://en.wikipedia.org/wiki/Myxedema#Symptoms"><span class="tocnumber">1</span> <span class="toctext">Symptoms</span></a> </li>
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                <li class="toclevel-1"><a href="http://en.wikipedia.org/wiki/Myxedema#Causes"><span class="tocnumber">2</span> <span class="toctext">Causes</span></a> </li>
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                <li class="toclevel-1"><a href="http://en.wikipedia.org/wiki/Myxedema#Treatment"><span class="tocnumber">3</span> <span class="toctext">Treatment</span></a> </li>
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                <li class="toclevel-1"><a href="http://en.wikipedia.org/wiki/Myxedema#See_also"><span class="tocnumber">4</span> <span class="toctext">See also</span></a> </li>
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<p><a id="Symptoms" name="Symptoms"></a></p>
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<h2><span class="editsection">[<a title="Edit section: Symptoms" href="http://en.wikipedia.org/w/index.php?title=Myxedema&amp;action=edit&amp;section=1">edit</a>]</span> <span class="mw-headline">Symptoms</span></h2>
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<p>Myxedema usually presents itself with some of the following symptoms:</p>
 
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     <li>정의<br />-[[점액수종]]<br />-[[갑상선 기능저하증]]의 가장 심한 형태</li>
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     <li>Skin thickening </li>
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    <li>Coarse skin </li>
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<p><br /><br />[[image:점액수종1.jpg]]<br />&lt;출처 :<font color="#000000"> <font size="2">www.meddean.luc.edu&gt;</font><br /></font><br /></p>
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    <li>Change in facial appearance </li>
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    <li>Thickening nose </li>
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     <li>내용<br />-손, 얼굴, 안와 주위 조직의 종창이 특징 </li>
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    <li>Swollen lips </li>
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    <li>Puffiness around the eyes </li>
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    <li>Jelly-like infiltrations in <a class="mw-redirect" title="Subcutaneous" href="http://en.wikipedia.org/wiki/Subcutaneous">subcutaneous</a> tissues </li>
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    <li>Slow speech </li>
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    <li>Mental dullness </li>
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    <li>Lethargy </li>
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    <li>Mental problems </li>
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    <li>Dry skin </li>
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    <li>Yellow skin </li>
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    <li>Swollen <a class="mw-redirect" title="Subcutaneous" href="http://en.wikipedia.org/wiki/Subcutaneous">subcutaneous</a> tissue </li>
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    <li>Weight gain </li>
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    <li><a title="Constipation" href="http://en.wikipedia.org/wiki/Constipation">Constipation</a> </li>
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    <li>Thinning hair </li>
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    <li>Brittle hair </li>
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    <li>Bald patches </li>
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    <li>Muscle pains </li>
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    <li><a class="mw-redirect" title="Deafness" href="http://en.wikipedia.org/wiki/Deafness">Deafness</a> </li>
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    <li><a title="Hearing impairment" href="http://en.wikipedia.org/wiki/Hearing_impairment">Hearing impairment</a> </li>
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     <li><a title="Carpal tunnel syndrome" href="http://en.wikipedia.org/wiki/Carpal_tunnel_syndrome">Carpal tunnel syndrome</a> </li>
 
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<p><a id="Causes" name="Causes"></a></p>
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<h2><span class="editsection">[<a title="Edit section: Causes" href="http://en.wikipedia.org/w/index.php?title=Myxedema&amp;action=edit&amp;section=2">edit</a>]</span> <span class="mw-headline">Causes</span></h2>
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<p>Myxedema stemming from both the <a class="mw-redirect" title="Hyperthyroid" href="http://en.wikipedia.org/wiki/Hyperthyroid">hyperthyroid</a> and <a class="mw-redirect" title="Hypothyroid" href="http://en.wikipedia.org/wiki/Hypothyroid">hypothyroid</a> conditions, results from the accumulation of increased amounts of <a class="mw-redirect" title="Hyaluronic acid" href="http://en.wikipedia.org/wiki/Hyaluronic_acid">hyaluronic acid</a> and <a title="Chondroitin sulfate" href="http://en.wikipedia.org/wiki/Chondroitin_sulfate">chondroitin sulfate</a> in the <a title="Dermis" href="http://en.wikipedia.org/wiki/Dermis">dermis</a> in both lesional and normal skin. The mechanism that causes myxedema is still not yet understood, although animal model studies suggest that <a title="Thyroid" href="http://en.wikipedia.org/wiki/Thyroid">thyroid</a> <a class="mw-redirect" title="Hormones" href="http://en.wikipedia.org/wiki/Hormones">hormones</a> affect the <a title="Synthesis" href="http://en.wikipedia.org/wiki/Synthesis">synthesis</a> and <a title="Catabolism" href="http://en.wikipedia.org/wiki/Catabolism">catabolism</a> of <a class="mw-redirect" title="Mucopolysaccharides" href="http://en.wikipedia.org/wiki/Mucopolysaccharides">mucopolysaccharides</a> and <a title="Collagen" href="http://en.wikipedia.org/wiki/Collagen">collagen</a> by dermal <a class="mw-redirect" title="Fibroblasts" href="http://en.wikipedia.org/wiki/Fibroblasts">fibroblasts</a>. The fibroblasts in the <a title="Orbit (anatomy)" href="http://en.wikipedia.org/wiki/Orbit_%28anatomy%29">orbital</a> and <a class="new" title="Pretibial (page does not exist)" href="http://en.wikipedia.org/w/index.php?title=Pretibial&amp;action=edit&amp;redlink=1">pretibial</a> <a title="Dermis" href="http://en.wikipedia.org/wiki/Dermis">dermis</a> share <a class="mw-redirect" title="Antigenic" href="http://en.wikipedia.org/wiki/Antigenic">antigenic</a> sites that underlie the <a class="mw-redirect" title="Autoimmune" href="http://en.wikipedia.org/wiki/Autoimmune">autoimmune</a> process that causes <a class="mw-redirect" title="Grave's disease" href="http://en.wikipedia.org/wiki/Grave%27s_disease">Grave's disease</a>. This cross-reaction may contribute to the development of myxedema long after normal levels of thyroid hormones have been restored by treatment.</p>
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<h2><span class="editsection">[<a title="Edit section: Treatment" href="http://en.wikipedia.org/w/index.php?title=Myxedema&amp;action=edit&amp;section=3">edit</a>]</span> <span class="mw-headline">Treatment</span></h2>
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<p>Treatment for myxedema is difficult. Systemic or <a class="new" title="Intralesional (page does not exist)" href="http://en.wikipedia.org/w/index.php?title=Intralesional&amp;action=edit&amp;redlink=1">intralesional</a> <a class="mw-redirect" title="Glucocorticoids" href="http://en.wikipedia.org/wiki/Glucocorticoids">glucocorticoids</a>, <a title="Topical" href="http://en.wikipedia.org/wiki/Topical">topical</a> <a class="mw-redirect" title="Glucocorticoids" href="http://en.wikipedia.org/wiki/Glucocorticoids">glucocorticoids</a> under <a title="Occlusion" href="http://en.wikipedia.org/wiki/Occlusion">occlusion</a> or high-dose <a class="mw-redirect" title="Intravenous" href="http://en.wikipedia.org/wiki/Intravenous">intravenous</a> <a class="mw-redirect" title="Immunoglobulin" href="http://en.wikipedia.org/wiki/Immunoglobulin">immunoglobulin</a> have been reported to offer some relief to patients. Treatment should follow correction of the original hyperthyroidism/hypothyroidism.</p>
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<h2><span class="editsection">[<a title="Edit section: See also" href="http://en.wikipedia.org/w/index.php?title=Myxedema&amp;action=edit&amp;section=4">edit</a>]</span> <span class="mw-headline">See also</span></h2>
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<p>Severe hypothyroidism in a child is called <a title="Cretinism" href="http://en.wikipedia.org/wiki/Cretinism">Cretinism</a> -<br />
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Revision as of 08:35, 11 March 2008

Myxedema (British English: myxoedema) is a skin and tissue disorder usually due to severe prolonged hypothyroidism. Hypothyroidism can be caused by Hashimoto's thyroiditis, surgical removal of the thyroid, and rarer conditions. Partial forms of myxedema, especially of the lower legs (called pretibial myxedema), occasionally occur in adults with Graves' disease, a cause of hyperthyroidism; or also Hashimoto's thyroiditis without severe hypothyroidism.

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[edit] Symptoms

Myxedema usually presents itself with some of the following symptoms:

[edit] Causes

Myxedema stemming from both the hyperthyroid and hypothyroid conditions, results from the accumulation of increased amounts of hyaluronic acid and chondroitin sulfate in the dermis in both lesional and normal skin. The mechanism that causes myxedema is still not yet understood, although animal model studies suggest that thyroid hormones affect the synthesis and catabolism of mucopolysaccharides and collagen by dermal fibroblasts. The fibroblasts in the orbital and pretibial dermis share antigenic sites that underlie the autoimmune process that causes Grave's disease. This cross-reaction may contribute to the development of myxedema long after normal levels of thyroid hormones have been restored by treatment.

[edit] Treatment

Treatment for myxedema is difficult. Systemic or intralesional glucocorticoids, topical glucocorticoids under occlusion or high-dose intravenous immunoglobulin have been reported to offer some relief to patients. Treatment should follow correction of the original hyperthyroidism/hypothyroidism.

[edit] See also

Severe hypothyroidism in a child is called Cretinism -



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