Myxedema: Record of an Autopsied Case with Special Emphasis upon Lesions of Muscles

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Abstract
This is a clinical and pathological description of a long standing case of complete hypothyroidism complicated by marked undernutrition. Clinically it was characterized by atrophy of the skin, pur-pura, hypocholesterolemia, hypoproteinemia, ascites, and gross segmental dilatation of the colon. Pathologically, muscle cells exhibited degeneration of the sarcoplasm with vacuoles of basophilic material. This was evident in cardiac and skeletal muscles and in the muscles of large and small arteries and of the esophagus, sigmoid colon, gall bladder, urinary bladder and uterus. The lesions in the muscles of the arteries were indistinguishable from those described by Erdheim as idiopathic cystic medial necrosis and by Kountz and Hempelmann in spontaneous rupture of the aorta in induced hypothyroidism.

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