Pulmonary manifestations of endocrine and metabolic disorders.

In summary, there are a number of important respiratory manifestations of endocrine diseases. Hypothyroidism may be associated with respiratory failure that can be caused by a reduction in central respiratory drive, upper airway obstruction, and associated restrictive pulmonary function from pleural effusions or an intrinsic decrease in lung volumes. Hyperthyroidism can present with dyspnea as a major clinical manifestation because of the increase in central respiratory drive associated with thyrotoxicosis. Cardiac dysfunction associated with hyperthyroidism may lead to pulmonary edema in some patients. Hypoparathyroidism may occur acutely, especially after thyroid surgery and be associated with hypocalcemia and acute tetany, laryngeal stridor, and muscle weakness. Ovarian tumors, both benign and malignant, may present with unilateral or bilateral effusions. Finally, patients with diabetes mellitus are at increased risk of developing a variety of pulmonary disorders. Acute and chronic pulmonary infections are the most common respiratory abnormalities in patients with diabetes, although cardiogenic and noncardiogenic pulmonary edema can also be a complication of their disease.