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Disorders associated with antidiuretic hormone (ADH)

As a result of fluid accumulation, the face takes on a characteristic puffy look, especially around the eyes. The tongue is enlarged, and the voice is hoarse and husky. Myxedematous fluid can collect in the interstitial spaces of almost any organ system. Pericardial or pleural effusion may develop. Mucopolysaccharide deposits in the heart cause generalized cardiac dilatation, bradycardia, and other signs of altered cardiac function. Pathophysiology 176 Diagnosis – Low serum T4 – Low resin T3 – Elevated TSH – Antithyroid test- if hashimato’s is suspected – TRH stimulation test in secondary hypothyroidism Myxedematous coma Myxedematous coma is a life-threatening end-stage expression of hypothyrodism. It is characterized by coma, hypothermia, cardiovascular collapse, hypoventilation, and severe metabolic disorders that include hyponatremia, hypoglyoemia, and lactic acidosis. It occurs most often in the elderly and is seldom seen in persons under age 50. The fact that it occurs more frequently in winter months suggests that cold exposure may be a precipitating factor. The severely hypothyroid person is unable to metabolize sedatives, analgesics, and anesthetic drugs, and these agents may precipitate coma.