|
localized (pretibial) myxedema
| • | found in 1-4% of patients with Grave’s disease, especially those with exophthalmos |
| • | may not develop until after the correction of hyperthyroidism (e.g. after thyroidectomy) |
| • | treatment of hyperthyroid does not improve lesion and, often, pretibial myxedema develops after it |
| • | pathogenesis: a circulating factor which stimulates increases synthesis of glycosaminoglycans (but not LATS – long acting thyroid stimulator) |
generalized myxedema
| • | manifestation of severe hypothyroidism |
| • | does not occur in secondary hypothyroidism (i.e. low TSH) |
| • | most pronounced around eyes, nose, and cheeks, often giving characteristic facies |
| • | suggested that pathogenesis is impaired degradation |
|