Mechanisms of edema formation in myxedema--increased protein extravasation and relatively slow lymphatic drainage

H H Parving, J M Hansen, S L Nielsen, Niels Nygaard Rossing, O Munck, N A Lassen

177 Citations (Scopus)

Abstract

We assessed extravascular accumulation of albumin and fluid in primary myxedema by measuring metabolic turnover and transcapillary escape of 131I-labeled human albumin in seven patients. In the hypothyroid state, we found a low plasma volume (P less than 0.05), a reduced rate of albumin synthesis and catabolism (P less than 0.01), an increased transcapillary escape rate of albumin (P less than 0.01), a remarkable increase in the extravascular mass of albumin (1500 micronmol; P less than 0.01) and a longer mean transit time through the extravascular spaces in primary myxedema than in other states of generalized edema (P less than 0.05). All variables returned to normal during l-thyroxine treatment. The extravascular accumulation of albumin, and presumably of all other plasma proteins, is important in the generalized edema typically found in myxedema. Inadequate lymphatic drainage may also explain the formation of exudates in the serous cavities that are well known in myxedema.
Original languageEnglish
JournalNew England Journal of Medicine
Volume301
Issue number9
Pages (from-to)460-5
Number of pages6
ISSN0028-4793
DOIs
Publication statusPublished - 30 Aug 1979

Keywords

  • Adult
  • Aged
  • Blood Proteins
  • Body Fluids
  • Capillary Permeability
  • Female
  • Humans
  • Hypothyroidism
  • Lymph
  • Male
  • Middle Aged
  • Myxedema
  • Serum Albumin, Radio-Iodinated
  • Skin

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