Refractory Pericardial Effusion Secondary to Central Hypothyroidism due to Empty Sella Syndrome: A Rare Case Report

Bishal Mandal; Prativa Subedi; Bishal Kumar Yadav; Bipin Pandey; Bishwa Raj Adhikari; Milan Gaihre

doi:10.1002/ccr3.73399

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Refractory Pericardial Effusion Secondary to Central Hypothyroidism due to Empty Sella Syndrome: A Rare Case Report

Bishal Mandal, Prativa Subedi, Bishal Kumar Yadav, Bipin Pandey, Bishwa Raj Adhikari, Milan Gaihre

Clinical Case Reports2026doi:10.1002/ccr3.73399

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Abstract

ABSTRACT Refractory pericardial effusion with a low free T4 but inappropriately normal TSH should prompt evaluation for central hypothyroidism, including pituitary MRI to identify treatable causes such as empty sella syndrome. Glucocorticoid cover must precede levothyroxine to prevent adrenal crisis in patients with possible hypopituitarism.

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Bishal Mandal#1 Prativa Subedi#2 Bishal Kumar Yadav#3 Bipin Pandey#4 Bishwa Raj Adhikari#5 Milan Gaihre#7

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Refractory Pericardial Effusion Secondary to Central Hypothyroidism due to Empty Sella Syndrome: A Rare Case Report

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