Abstract

We assessed skin accumulation of acid glycosaminoglycans in ten patients with primary myxoedema (median age 70 years) before and during l-thyroxine treatment (median 7 months). Eight subjects matched for sex and age served as controls. Acid glycosaminoglycans were determined biochemically on small skin biopsies. Hyaluronic acid was elevated in untreated myxoedema, median 0.60, range 0.39-0.90 microgram hexosamine/mg dried defatted tissue compared to a median control value of 0.52, range 0.43-0.65 microgram hexosamine/mg dried defatted tissue, P less than 0.02. Chondroitin-4,6-sulphate and dermatan sulphate showed no elevation, while heparan sulphate was actually reduced in myxoedema, P less than 0.01. l-thyroxine treatment induced a significant reduction in hyaluronic acid, median 0.41, range 0.24-0.71 microgram hexosamine/mg dried defatted tissue, while no consistent changes occurred in the remaining three acid glycosamine glycans. The accumulation of hyaluronic acid might contribute to the peculiar non-pitting oedema of the skin in myxoedema, due to the strong water-binding capacity of the substance.

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