Hypothyroidism May Initially be Mistaken as Abdominal Cancer

mrhealthie · 10-05-2009, 08:31 PM

October, 2002 -- According to research reported on in the British Medical Journal, thyroid function should be checked in all patients with a condition called ascites (pronounced ah-sih-tez) -- an abnormal accumulation of fluid in the abdomen.

Ascites are considered a symptom of severe (and often undetected) hypothyroidism. It's considered to be a fairly known but not common feature of hypothyroidism, occurring in as many as 4% of patients.

Symptoms of ascites are:

* Rapid weight gain
* Abdominal discomfort and distention
* Shortness of breath
* Swollen ankles

The British Medical Journal reported on a case in which a woman had ascites and an elevated CA 125 concentration. The 74-year-old woman had increasingly worsening abdominal swelling along with shortness of breath and fatigue. Her doctor had preliminarily diagnosed some sort of abdominal cancer.

Other symptoms included:

* a hoarse voice
* low-grade fever
* slighly elevated blood pressure
* some swelling in the feet
* ascites
* elevated tumour marker / CA 125 concentration
* dry skin

Her oncologist suspected ovarian cancer, or a metastatic stomach cancer. CAT scans, laparoscopy and various other tests, however, showed no evidence of cancer.

Finally, testing was done for thyroid function, and her TSH level was 73 (normal range 0.2-5.7) and free T4 was 5 (normal range 9-19 pmol/l). She had elevated thyroid peroxidase antibody levels.

As her thyroxine level was raised from 25 to 100 micrograms a day, her CA 125 levels returned to normal, and she had no ascites.

The researchers concluded that CA 125 levels in patients with hypothyroidism and ascites can be as high as those seen in patients with cancer, suggesting that any patient with ascites and a raised CA 125 concentration should have thyroid function measured as part of their initial evaluation.

nonstickpam107 · 10-06-2009, 05:44 AM

And, um, the conclusion is that here in the USA, they don't use a CA 125 as a diagnostic tool so much as a tool to see how treatment is affecting.

Yes, ascites has always been part of hypothyroidism especially when Hashimoto's disease is present.

(and they didn't have to say it was from the British med journal as soon as you only saw a TSH and a FT4...I'd love to know what the FT3 and actual TPO was.).

Pam

10-05-2009, 08:31 PM	#1
mrhealthie Junior LCF Member Join Date: Oct 2009 Posts: 2 Gallery: mrhealthie	Hypothyroidism May Initially be Mistaken as Abdominal Cancer October, 2002 -- According to research reported on in the British Medical Journal, thyroid function should be checked in all patients with a condition called ascites (pronounced ah-sih-tez) -- an abnormal accumulation of fluid in the abdomen. Ascites are considered a symptom of severe (and often undetected) hypothyroidism. It's considered to be a fairly known but not common feature of hypothyroidism, occurring in as many as 4% of patients. Symptoms of ascites are: * Rapid weight gain * Abdominal discomfort and distention * Shortness of breath * Swollen ankles The British Medical Journal reported on a case in which a woman had ascites and an elevated CA 125 concentration. The 74-year-old woman had increasingly worsening abdominal swelling along with shortness of breath and fatigue. Her doctor had preliminarily diagnosed some sort of abdominal cancer. Other symptoms included: * a hoarse voice * low-grade fever * slighly elevated blood pressure * some swelling in the feet * ascites * elevated tumour marker / CA 125 concentration * dry skin Her oncologist suspected ovarian cancer, or a metastatic stomach cancer. CAT scans, laparoscopy and various other tests, however, showed no evidence of cancer. Finally, testing was done for thyroid function, and her TSH level was 73 (normal range 0.2-5.7) and free T4 was 5 (normal range 9-19 pmol/l). She had elevated thyroid peroxidase antibody levels. As her thyroxine level was raised from 25 to 100 micrograms a day, her CA 125 levels returned to normal, and she had no ascites. The researchers concluded that CA 125 levels in patients with hypothyroidism and ascites can be as high as those seen in patients with cancer, suggesting that any patient with ascites and a raised CA 125 concentration should have thyroid function measured as part of their initial evaluation.

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10-06-2009, 05:44 AM	#2
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Posts: 17,686 Gallery: nonstickpam107	And, um, the conclusion is that here in the USA, they don't use a CA 125 as a diagnostic tool so much as a tool to see how treatment is affecting. Yes, ascites has always been part of hypothyroidism especially when Hashimoto's disease is present. (and they didn't have to say it was from the British med journal as soon as you only saw a TSH and a FT4...I'd love to know what the FT3 and actual TPO was.). Pam