Key result
Treatment with thyroid hormone alone resolved a large, recurrent pericardial effusion and normalized elevated tumor markers in a patient with hypothyroidism.
Why the study?
Accurately diagnosing the cause of large pericardial effusion is important for determining proper treatment based on clinical characteristics.
Case Report (n=1)
Hypothyroidism can present with large pericardial effusions and elevated tumor markers, both of which can resolve completely with thyroid hormone replacement therapy alone.
Hypothyroidism warrants consideration in unexplained large pericardial effusions with elevated tumor markers; leaves open whether targeted screening improves outcomes.
Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.
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Lee et al. (2021) conducted a case report in Large, recurrent pericardial effusion accompanied by hypothyroidism (n=1). Thyroid hormone was evaluated on Resolution of pericardial effusion and normalization of tumor markers. Treatment with thyroid hormone alone resolved a large, recurrent pericardial effusion and normalized elevated tumor markers in a patient with hypothyroidism.
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