Primary Myxedema With Secondary Adrenocortical Failure

DEFICIENCY of thyroid hormone is known to result in generalized alteration in cellular function. Most commonly the clinical manifestations of myxedema are noted in the skin, musculature, and cardiovascular and central nervous systems. Less emphasized is the effect of deficient thyroid hormone on the other endocrine glands, particularly the adrenals. Hypofunction of the adrenal cortex has been shown to occur in patients with myxedema (1). The manifestations of these secondary effects on endocrine function may overshadow the changes resulting from myxedema, and mask the underlying primary disease. The following is considered a case of primary myxedema in which the presenting findings were those of adrenocortical insufficiency: Case #13343—A 32-year-old white male of Portuguese extraction was admitted in October 1952, to the Neuropsychiatric Service of the Providence Veterans Hospital with a diagnosis of neurasthenia. The patient stated that he was well until two years prior to admission, when progressive weakness and fatigue had developed. About that time his wife died following childbirth.