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Chylous Ascites Due to Hyperthyroidism and Heart Failure
Authors:Masaki Uchihara  Jun Ehara  Keiichi Iwanami  Koichi Kitamura  Toshihiko Suzuki  Noriyoshi Ishizuka  Toru Yamada  Eiji Hiraoka
Abstract:Chylous ascites (CA) is the accumulation of fluid with a high triglyceride content in the peritoneal cavity. Only two cases in the literature have reported CA with hyperthyroidism. A 28-year-old previously healthy woman presented with gradual-onset abdominal swelling, exertional dyspnea, and diarrhea. Hyperthyroidism and heart failure were diagnosed using laboratory investigation and echocardiography. Ultrasonography revealed a large amount of ascites. The ascitic fluid was milky with elevated triglyceride levels. Treatment with anti-thyroid therapy and diuretics improved all symptoms, and the free triiodothyronine (T3) level normalized after five days. Hyperthyroidism and heart failure should be considered as reversible causes of CA.
Keywords:chylous ascites   thyroid storm   hyperthyroidism   heart failure
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