INFLUENCE OF HORMONE THERAPY ON BODY FLUIDS, ELECTROLYTE BALANCE AND MUCOPOLYSACCHARIDES IN MYXEDEMA*†

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Abstract
Two female patients, 1 with primary, and 1 with pituitary myxedema were studied. The patient with pituitary myxedema, during thyrotropin treatment, showed expansion of extracellular fluid space (thiosulfate) and total body water (antipyrine), with subsequent contraction of extracellular fluid space. There was an associated slight retention of Na and Cl, and a slight weight loss. During treatment with desiccated thyroid, both patients demonstrated transient expansion of extracellular fluid space with essentially parallel changes in total body water, weight loss, and increased urine volume. Na and Cl balances became negative in the patient with primary myxedema. The other patient showed Na and Cl retention, but to a lesser degree than during the preceding control period. In the patient with primary myxedema there was an increase in urinary hexosamine and a transient increase in the level of serum mucoprotein; in the other patient, there occurred an increase in urinary and serum hexosamine levels at the end of the period. The patient with primary myxedema, under treatment with cortisone prior to thyroid administration, demonstrated moderate expansion of the extracellular fluid space, associated with Na and Cl retention and weight gain. Some rise in the concentration of serum mucoprotein was noted. During combined thyroid-cortisone administration, there occurred greater expansion of extracellular fluid space, and negative Na and Cl balances, with constant weight. The patient with pituitary myxedema, during treatment with thyroid and cortisone, showed transient extracellular space expansion. In both patients there was a considerable increase in urinary hexosamine during combined thyroid-cortisone treatment, not observable in the patient with primary myxedema receiving cortisone alone. There was a slight rise in serum mucopoly-saccharide fractions in both patients during combined therapy.