Eyebrow loss and the Queen Anne sign in hypothyroidism

An 85-year-old woman was transferred to our hospital after a 2-day history of difficulty in getting out of bed and eating. She also experienced edema in the limbs for several years and was taking furosemide, but it was ineffective. She did not have any other medical history. Physical examination revealed a blood pressure of 134/61  mmHg, pulse rate of 62 beats/min, respiratory rate of 10 beats/min and body temperature of 35.7°C. The patient’s Glasgow Coma Scale score was 14 (E4V4M6). We observed limb and periorbital edema, as well as loss of the outer third of the eyebrows (Figure  1) and dry skin. Laboratory findings showed levels of the thyroid-stimulating hormone at 62.70 (normal 0.61 –4.23) mIU/ml, free thyroxine at 0.83 (normal 0.90–1.70) ng/dl and free triiodothyronine at 0.99 (normal 2.30–4.00) pg/ml. We diagnosed her with hypothyroidism and prescribed levothyroxine at 25 μg/day orally; 1 month later, we increased the dosage to 50 μg/day.
Source: QJM - Category: Internal Medicine Source Type: research