患者女,70岁。患者原有甲减病史二十余年,平素自服甲状腺片40mg/日。停药二年后因出现左侧胸腔积液、心包积液伴反复双上肢抽搐一月余入院。无甲状腺手术史及放疗史。产3子,足月顺产。家族无类似疾病。入院查体:T36.8℃,P80次/分。神情淡漠,反应迟钝,粘液水肿面容。全身皮肤呈鱼鳞状改变,甲状腺无肿大;左肺呼吸音低,叩诊呈浊 Female patient, 70 years old. Patients with a history of hypothyroidism for more than twenty years, usually from the thyroid tablets 40mg / day. Two years after the withdrawal due to the emergence of the left pleural effusion, pericardial effusion with repeated upper limb twitch more than one month hospitalization. No history of thyroid surgery and radiotherapy. 3 children, full-term birth. The family has no similar disease. Admission examination: T36.8 ℃, P80 beats / min. Indifferent, unresponsive, mucus edema face. Squamous body was skin changes, no swelling of the thyroid; left lung breath sounds low, percussion was turbid