점액부종 복수와 결핵성 복막염이 혼재된 증례 1예
Coexistence of Myxedema Ascites and Tuberculous Peritonitis: a Case Report and Literature Review
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초록
점액부종 복수와 결핵성 복막염이 동시에 나타나는 경우는 매우 드문 경우이며, 두 질환의 복수 발생 기전이 상이하므로 동반될 경우 감별 진단에 어려움을 겪을 수 있기에, 주의를 기울여야 하겠다.
Abstract
Some patients have ascites without having liver disease, so it is important to analyze the cause of these ascites. Tuberculous peritonitis is an infectious disease characterized by lymphocyte-dominant exudative ascites. In contrast, myxedema ascites is a very rare disease characterized by a high serum/ascites albumin gradient (SAAG) with hypothyroidism. We herein report a case involving a 48-year-old woman with both diseases simultaneously. She was hospitalized because of massive ascites, generalized edema, and a puffy face. Hypothyroidism was confirmed by thyroid function tests. Her ascitic fluid had a high SAAG; no other specific findings were identified by cytology, culture, or computed tomography. Three months after initiating drug therapy for the hypothyroidism, the patient’s systemic edema improved but the ascites recurred. Accordingly, diagnostic laparoscopy was performed, and tuberculous peritonitis was confirmed. As seen in this case, when myxedema ascites is associated with tuberculous peritonitis, an accurate diagnosis may be challenging. (Korean J Med 2016;91:179-184)
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