{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:26Z","timestamp":1790310446409,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 77\u2010year\u2010old man with COPD and hypertension presented with progressive exertional dyspnea over 3\u2009months. Physical examination revealed decreased breath sounds in the right lung base and signs suggestive of hypothyroidism, including dry skin and lateral eyebrow thinning. CT imaging showed emphysematous changes with moderate right pleural effusion. Pleural fluid analysis consistently showed borderline transudate\/exudate characteristics. Comprehensive evaluation excluded heart failure, malignancy, pulmonary embolism and abdominal pathology. Subsequent thyroid function tests confirmed profound hypothyroidism (TSH: 49.6\u2009\u03bcIU\/mL). Levothyroxine therapy was initiated and titrated. Remarkably, follow\u2010up imaging after 4\u2009months demonstrated complete resolution of the pleural effusion, with normalised thyroid function and significant symptomatic improvement. Isolated pleural effusion represents an uncommon manifestation of hypothyroidism. The pathogenic mechanism may involve reduced albumin synthesis and increased vascular permeability, potentially mediated by TSH\u2010stimulated VEGF production. This case is notable for the absence of classic myxedema symptoms while presenting significant pleural effusion. The diagnosis was established only after methodical exclusion of more common etiologies. Levothyroxine replacement therapy proved effective, resulting in complete effusion resolution.<\/jats:p>","DOI":"10.1002\/rcr2.70397","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T03:23:16Z","timestamp":1762312996000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Isolated Unilateral Pleural Effusion Associated With Hypothyroidism: A Case Report and Review of the Literature"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2420-8933","authenticated-orcid":false,"given":"Hesam","family":"Amini","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Imam Khomeini Hospital Complex Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereshteh","family":"Attaran","sequence":"additional","affiliation":[{"name":"Metabolic Diseases Research Center, Research Institute for Prevention of Non\u2010Communicable Diseases Qazvin University of Medical Sciences  Qazvin Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9533-0103","authenticated-orcid":false,"given":"Sara","family":"Soltanmohammadi","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care Department, Advanced Thoracic Research Center, Imam Khomeini Medical Center Tehran University of Medical Siences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30703-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc6218"},{"issue":"12","key":"e_1_2_8_4_1","article-title":"Ascites, Pleural, and Pericardial Effusion in Primary Hypothyroidism: A Rare Case Report","volume":"15","author":"Gomes Santos P.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23547"},{"key":"e_1_2_8_6_1","first-page":"1792","volume-title":"Murray & Nadel's Textbook of Respiratory Medicine","author":"Mason R. 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