Abstract
Myxedema coma is a decompensated state of hypothyroidism characterized by diminished mental status, thermal dysregulation, and other hypothyroid signs and symptoms and can lead to a fatal outcome if not recognized immediately and treated promptly. Myxedema coma (MC) is most commonly seen in older women in the winter months. It should be suspected in a clinically hypothyroid patient with altered mentation, hypothermia, hypotension, and bradycardia.
There are myriad cardiac, neurocognitive, respiratory, and renal manifestations of myxedema coma that can serve as clinical clues in evaluating patients suspected of myxedema coma. Diagnosis is clinical and confirmed by biochemical analysis including thyroid function tests, as well as determining what precipitated it. A high index of suspicion for myxedema coma should prompt urgent treatment with supportive cardiopulmonary measures, glucocorticoids for treatment of possible undiagnosed concomitant adrenocortical deficiency, thyroid hormone supplementation, and management of inciting factors.
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Abbreviations
- AST:
-
aspartate aminotransferase
- ATA:
-
American Thyroid Association
- GCS:
-
Glasgow Coma Scale
- GFR:
-
glomerular filtration rate
- LDH:
-
Lactate dehydrogenase
- LDL:
-
Low-density lipoprotein
- LT3:
-
Liothyronine
- LT4:
-
Levothyroxine
- MC:
-
Myxedema coma
- NTI:
-
Nonthyroidal illness
- T3:
-
Triiodothyronine
- T4:
-
Thyroxine
- TSH:
-
Thyroid-stimulating hormone
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Jack, G.A., Hennessey, J.V. (2020). Myxedema Coma. In: Garg, R., Hennessey, J., Malabanan, A., Garber, J. (eds) Handbook of Inpatient Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-38976-5_5
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