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Concept
Myxœdème
Résumé
Myxedema is a term used synonymously with severe hypothyroidism. However, the term is also used to describe a dermatological change that can occur in hypothyroidism and (rare) paradoxical cases of hyperthyroidism. In this latter sense, myxedema refers to deposition of mucopolysaccharides in the dermis, which results in swelling of the affected area. One manifestation of myxedema occurring in the lower limb is pretibial myxedema, a hallmark of Graves disease, an autoimmune form of hyperthyroidism. Myxedema can also occur in Hashimoto thyroiditis and other long-standing forms of hypothyroidism.
The word myxedema originates from μύξᾰ, taken from ancient Greek to convey 'mucus' or 'slimy substance', and οἴδημα for "swelling". It can also be thought of as nonpitting edema, in contrast to pitting edema.
Myxedema can occur in the lower leg (pretibial myxedema) and behind the eyes (exophthalmos).
Severe cases, requiring hospitalization can exhibit signs of hypothermia, hypoglycemia, hypotension, respiratory depression, and coma.
Myxedema is known to occur in various forms of hyperthyroidism, including Graves disease. One of the hallmarks of Grave's disease is pretibial myxedema, myxedema of the lower limb.
Myxedema is more common in women than in men.
Myxedema can occur in:
Hyperthyroidism, associated with pretibial myxedema and exophthalmos. Pretibial myxedema can occur in 1–4% of patients with Graves' disease, a cause of hyperthyroidism.
Hypothyroidism, including Hashimoto's thyroiditis.
Myxedema describes a specific form of cutaneous and dermal edema secondary to increased deposition of connective tissue components. The connective fibres are separated by an increased amount of protein and mucopolysaccharides. These can include glycosaminoglycans, such as hyaluronic acid, chondroitin sulfate and other mucopolysaccharides. This protein-mucopolysaccharide complex binds water, producing non-pitting boggy edema, in particular around eyes, hands, feet and in the supraclavicular fossae.
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