eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-08-20 8 12 447 450 10.12691/ajmcr-8-12-3 AJMCR20208123 article Chukwuemeka A. Umeh Chukwuemeka.umeh@phh.ms 1 Ankit Dubey 1 Stella Onyi 2 Department of Internal Medicine, Hemet Valley Medical Center, Hemet, California, USA Department of Radiology, Hemet Valley Medical Center, Hemet, California, USA Hypothyroidism is characterized by a broad clinical spectrum ranging from asymptomatic or subclinical hypothyroidism to overt myxedema and multisystem failure. Pericardial effusion occurs frequently in myxedema but is rare in other stages of hypothyroidism because of the timeliness in which hypothyroidism is nowadays detected and treated. The author reports a case of progressively worsening pericardial effusion from refractory hypothyroidism secondary to autoimmune atrophic gastritis. The approach to managing pericardial effusion complicating refractory hypothyroidism is discussed. http://pubs.sciepub.com/ajmcr/8/12/3/ajmcr-8-12-3.pdf pericardial effusion hypothyroidism refractory hypothyroidism autoimmune atrophic gastritis