Refractory Postsurgical Hypothyroidism in Nephrotic Syndrome

May 2021 in “ Journal of the Endocrine Society ”

Casey Rendon

hypothyroidism thyroidectomy thyroxine Armour thyroid edema proteinuria Synthroid

TLDR The patient's hypothyroidism improved with medication adjustments and careful management.

A 62-year-old female with a history of thyroid cancer and thyroidectomy experienced worsening edema and hypothyroidism symptoms despite increased thyroxine doses. She was diagnosed with severe hypothyroidism exacerbated by nephrotic syndrome due to membranous nephropathy, confirmed by kidney biopsy. Her treatment included IV steroids, thyroxine, albumin infusion, statin, ACE inhibitor, and diuretics. She stabilized on oral thyroxine after a single IV dose and was discharged with improved symptoms. Nephrology recommended conservative treatment due to her normal renal function and improving edema.

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