Myxedema coma | |
---|---|
Specialty | Endocrinology ![]() |
Symptoms | deterioration of the patient's mental status[1] |
Causes | infections (especially pneumonia and urosepsis), certain medications, failure to reinstate thyroid replacement therapy[1] |
Treatment | admission 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]
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