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, including hair loss, despite increasing her thyroid medication. She was diagnosed with severe hypothyroidism exacerbated by nephrotic syndrome due to membranous nephropathy, which caused significant proteinuria. Initial treatment included IV steroids, thyroxine, and diuretics, followed by oral thyroxine and discontinuation of Armour thyroid. Her condition improved with conservative management, and she remained stable on oral thyroxine with outpatient follow-up recommended.

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