Abstract
Myxedema coma may occur in a patient with hypothyroidism, either untreated or inadequately treated with thyroid hormone, who experiences a precipitating factor such as pneumonia, surgery, cold exposure, or treatment with medications that cause central nervous system depression. It is associated with hypothermia, lethargy or coma, hypoventilation with hypoxemia, carbon dioxide retention, and a respiratory acidosis. If unrecognized and inadequately treated, it carries a high mortality rate. Therapy consists of giving thyroxine, triiodothyronine, or a combination, preferably intravenously, as well as providing supportive measures such as mechanical ventilation (if needed), passive rewarming, vasopressor agents, fluid restriction, and glucocorticoids (especially if the patient has secondary hypothyroidism or autoimmune adrenal insufficiency). Aggressive therapy has decreased the mortality rate from close to 100 % to 30–50 %.
Keywords
- Thyroid Hormone
- Adrenal Insufficiency
- Intercurrent Illness
- Thyroid Hormone Replacement
- Central Hypothyroidism
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Donangelo, I., Braunstein, G.D. (2014). Myxedema Coma. In: Loriaux, L. (eds) Endocrine Emergencies. Contemporary Endocrinology, vol 74. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-697-9_10
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DOI: https://doi.org/10.1007/978-1-62703-697-9_10
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