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Mononuclear phagocyte system

The hypometabolic state associated with myxedema is characterized by a gradual onset of weakness and fatigue, a tendency to gain weight despite a loss in appetite, and cold intolerance. As the condition progresses, the skin becomes dry and rough and acquires a pale yellowish cast, which is due primarily to carotene deposition, and the hair becomes coarse and brittle. There is loss of the lateral one-third of the eyebrows. Gastrointestinal motility is decreased, giving rise to constipation, flatulence, and abdominal distention. Nervous system involvement is manifested in mental dullness, lethargy, and impaired memory. 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