Hipotiroidizmde Ödem Mekanizmaları

Öz

Hipotiroidizm plevral, perikardiyal efüzyon veya asit yapabilir. Miksödemin başlıca bulguları sıvı retansiyonu, hiponatremi ve hidrofilik mukopolisakkaritlerin intersisyel birikimidir. Hipotiroidizm glomerüler filtrasyon oranının azalması ile beraberdir. Azalmış glomerüler filtrasyon oranı ise idrarın dilüsyonundan sorumlu kısımlara gelen su miktarını azaltarak serbest su atılımını azaltır. Hipotiroidizme bağlı seröz efüzyonların genellikle protein düzeyleri yüksek olduğu için altta yatan mekanizma muhtemelen vasküler permeabilite artışıdır. Miksödem olgularında efüzyon oluşumunun gerçek mekanizması bilinmemektedir. Vasküler Endotelyal Growth Faktör kapiller permeabiliteyi artırmaktadır ve bu faktörün düzeyleri hipotiroidizm olgularında yüksek olup tiroid hormon replasman tedavisiyle normale dönmektedir

Anahtar Kelimeler

• Miksödem, Hipotiroidizm, Serozit

Edema Mechanisms in Hypothyroidism

Abstract

Hypothyroidism can cause pleural or pericardial effusion, and ascites. The main manifestations of myxedema include retention of fluid, hyponatremia, and interstitial deposition of hydrophilic mucopolysaccharides. Hypothyroidism is associated with reduced glomerular filtration rate. Reduced glomerular filtration rate can directly decrease free water excretion by diminishing water delivery to the diluting segments. As the serous effusions due to hypothyroidism have generally high levels of protein, the underlying mechanism is probably increased vascular permeability. The precise mechanism of effusion formation in patients with myxedema is unclear. Vascular Endothelial Growth Factor also increases capillary permeability. The levels of this factor are elevated in patients with hypothyroidism and return to normal with thyroid replacement therapy

Keywords

• Myxedema, Hypothyroidism, Serositis

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