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We report herein a case with myxedema (primary hypothyroidism) associated with marked ascites that was found during the course of examination for a suspected decompensated state of liver cirrhosis or malignant disease. Aspirated ascitic fluid was found to have the characteristics of the exudate. Thyroid hormone replacement resulted in rapid clinical improvement with resolution of the ascites. This case is an unusual association of hypothyroidism as a cause of ascites. In all the cases with ascites of unknown etiology, the differential diagnosis requires consideration of myxedema.

Gross Ascites as a First Manifestation of Primary Hypothyroidism due to Post-treatment of Radioiodine Therapy For Graves' disease.