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Case Report

JCDR. 2013; 4(4): 248-250

Massive pericardial effusion as the only manifestation of primary hypothyroidism

Radheshyam Purkait, Anand Prasad, Ramchandra Bhadra, Arindam Basu.


Small pericardial effusion (PE) is not an infrequent manifestation in primary hypothyroidism. But
massive PE with or without cardiac tamponade is rare and often associated with severe form of the
disease. Here we report an eight-year-old boy who was admitted with massive PE that required repeated
pericardiocentesis. Detailed examinations failed to identify the etiology initially. Five months later, child
was readmitted with massive PE with impending cardiac tamponade. Primary hypothyroidism was
diagnosed based on the clinical and laboratory finding and was thought to be the underlying etiology of
previously encountered undiagnosed massive PE. Beside pericardiocentesis, child was treated with
thyroid hormone replacement. Condition gradually improved without further recurrence of PE till date.
Therefore, irrespective of the presence of clinical signs, primary hypothyroidism should be suspected in
every patient presenting with massive PE to prevent recurrence as well as its serious complications like
cardiac tamponade.

Key words: Pericardial effusion Primary hypothyroidism Cardiac tamponade Levo-thyroxine

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