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 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%.
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Donangelo, I., Braunstein, G.D. (2021). Myxedema Coma. In: Loriaux, L., Vanek, C. (eds) Endocrine Emergencies. Contemporary Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-67455-7_10
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