Document Detail

Myxedema accompanied by huge portal-systemic shunt without portal hypertension.
MedLine Citation:
PMID:  11813844     Owner:  NLM     Status:  MEDLINE    
A 43-year-old woman with a huge portal-systemic shunt accompanied by myxedema showed slow speech and behavior. Several imaging studies revealed a bold portal-systemic shunt from the splenic vein to the left renal vein. In addition, hypothyroidism caused by chronic thyroiditis was diagnosed, and synthesized thyroxine replacement was effective for the symptoms. However, the serum ammonia and indocyanin green retention remained in the abnormal range, nevertheless the portal vein pressure was normal and findings of liver cirrohsis were not recognized histologically. Surgical shunt closure was performed, resulting in normalized serum ammonia levels and serum branched chain amino acids /aromatic amino acids ratio, and improvement of the ammonia tolerance test.
Y Yamaguchi; T Okai; H Watanabe; Y Motoo; M Mai; O Matsui; Y Nakanuma; N Sawabu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  40     ISSN:  0918-2918     ISO Abbreviation:  Intern. Med.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-29     Completed Date:  2002-07-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1200-4     Citation Subset:  IM    
Department of Internal Medicine and Medical Oncology, Cancer Research Institute, Kanazawa University.
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MeSH Terms
Ammonia / blood
Hypertension, Portal
Myxedema / blood,  complications*,  immunology,  pathology
Portal System / pathology
Renal Veins / pathology*,  radiography,  surgery
Severity of Illness Index
Splenic Vein / pathology*,  radiography,  surgery
Thyroiditis, Autoimmune / complications
Vascular Fistula / blood,  complications*,  radiography,  surgery
Reg. No./Substance:
Comment In:
Intern Med. 2001 Dec;40(12):1170-1   [PMID:  11813836 ]

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