Pathologic changes in adult myxedema: survey of 10 necropsies.

Abstract

THE pathology of adult myxedema as recorded in the literature is based upon the findings of relatively few autopsies. The opportunity has seldom been presented to study at necropsy either untreated or inadequately treated cases. The present study was initiated because of the availability of 10 such cases at the Wayne County General Hospital in a 15-year period. Typical clinical features of the myxedematous state were present in all. The first clinical recognition of myxedema has been attributed to Sir William Gull (1) in 1873. The first autopsy in a case of myxedema was reported in 1877 by Sir William Ord (2). The term “myxedema” was proposed by Ord, because the chief feature appeared to be a mucin-yielding edema involving chiefly the connective tissue. Subsequent authors described the similarity of spontaneous myxedema, cachexia strumipriva (post-thyroidectomy myxedema) and cretinism. Loss of thyroid function later became recognized as the common denominator of these states. The Report of a Committee of the Clinical Society of London (3) published in 1888 included the data on 20 autopsies of cases of myxedema. This publication is the classic source of reference for the pathology of myxedema. Since that time, 10 autopsies have been reported by Bastenie (4), and 9 by Means (5). A few single case reports have appeared (6–14). Two cases were studied by histochemical methods (6, 7).