Myxedema coma

Myxedema coma
SpecialtyEndocrinology Edit this on Wikidata
Symptomsdeterioration of the patient's mental status[1]
Causesinfections (especially pneumonia and urosepsis), certain medications, failure to reinstate thyroid replacement therapy[1]
Treatmentadmission to the intensive care unit, correct hypovolemia and electrolyte abnormalities, mechanical ventilation if needed, thyroid hormone replacement[1]

Myxedema coma is an extreme or decompensated form of hypothyroidism and while uncommon, is potentially lethal.[1][2][3] A person may have laboratory values identical to a "normal" hypothyroid state, but a stressful event (such as an infection, myocardial infarction, or stroke) precipitates the myxedema coma state, usually in the elderly. Primary symptoms of myxedema coma are altered mental status and low body temperature. Low blood sugar, low blood pressure, hyponatremia, hypercapnia, hypoxia, slowed heart rate, and hypoventilation may also occur.[4] Myxedema, although included in the name, is not necessarily seen in myxedema coma.[citation needed] Coma is also not necessarily seen in myxedema coma,[5] as patients may be obtunded without being comatose.[2]

According to newer theories, myxedema coma could result from allostatic overload in a situation where the effects of hypothyroidism are amplified by nonthyroidal illness syndrome.[6]

  1. ^ a b c d Wall, Cristen Rhodes (2000-12-01). "Myxedema Coma: Diagnosis and Treatment". American Family Physician. 62 (11): 2485–2490. ISSN 0002-838X. PMID 11130234.
  2. ^ a b Mathew, Vivek; Misgar, Raiz Ahmad; Ghosh, Sujoy; Mukhopadhyay, Pradip; Roychowdhury, Pradip; Pandit, Kaushik; Mukhopadhyay, Satinath; Chowdhury, Subhankar (2011-09-15). "Myxedema Coma: A New Look into an Old Crisis". Journal of Thyroid Research. 2011: 493462. doi:10.4061/2011/493462. PMC 3175396. PMID 21941682.
  3. ^ Elshimy, Ghada; Correa, Ricardo (2022). "Myxedema". StatPearls. StatPearls Publishing. PMID 31424777.
  4. ^ Van den Berghe, Greet, ed. (2008). Acute endocrinology: From Cause to Consequence (1 ed.). New York: Humana Press. pp. 29–44. ISBN 978-1-60327-176-9.
  5. ^ Gardner, David G., Shoback, Dolores M., Greenspan, Francis S. (2017). Greenspan's basic & clinical endocrinology (10th ed.). McGraw-Hill Education. p. 783. ISBN 978-1259589294. OCLC 1075522289.{{cite book}}: CS1 maint: multiple names: authors list (link)
  6. ^ Chatzitomaris, Apostolos; Hoermann, Rudolf; Midgley, John E.; Hering, Steffen; Urban, Aline; Dietrich, Barbara; Abood, Assjana; Klein, Harald H.; Dietrich, Johannes W. (20 July 2017). "Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming". Frontiers in Endocrinology. 8: 163. doi:10.3389/fendo.2017.00163. PMC 5517413. PMID 28775711.