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]
^ abcdWall, Cristen Rhodes (2000-12-01). "Myxedema Coma: Diagnosis and Treatment". American Family Physician. 62 (11): 2485–2490. ISSN 0002-838X. PMID 11130234.
^ abMathew, 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.
^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.
^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)
^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.
Myxedemacoma is an extreme or decompensated form of hypothyroidism and while uncommon, is potentially lethal. A person may have laboratory values identical...
hypothermia, hypoglycemia, hypotension, respiratory depression, and coma. Myxedema is known to occur in various forms of hypothyroidism, as well as hyperthyroidism...
they develop an acute illness. Myxedemacoma can be the first presentation of hypothyroidism. People with myxedemacoma typically have a low body temperature...
disorientation may be in the differential, including hypoglycemia and myxedemacoma. In the right setting, hypothermia should be ruled out. Weaver, MF (3...
hormone deficiency (hypothyroidism), including a severe form known as myxedemacoma. It may also be used to treat and prevent certain types of thyroid tumors...
delirium, and in extreme cases to hallucinations, coma, or psychosis, particularly in the elderly. "Myxedema" is a synonym with severe hypothyroidism. It was...
triiodothyronine (T3). It is most commonly used to treat hypothyroidism and myxedemacoma. It can be taken by mouth or by injection into a vein. Side effects...
interferences. Allostatic overload may result in wasting syndrome and myxedemacoma. Thyroid storm, though, represents allostatic failure, where the organism...
cancer spread from other parts of the body. Metabolic: hypothyroidism (myxedemacoma), severe protein deficiency Traumatic: penetrating or blunt chest trauma...
sarcoidosis. Some forms of hypothyroidism can result in myxedema and severe cases can result in myxedemacoma. Hypothyroidism is managed with replacement of the...
amount of it, the thyroid gland fails to produce enough thyroid hormone. Myxedemacoma is a rare but serious aspect of the disease that is a medical emergency...
should be used with caution in cases of liver disease, Addison's disease, myxedema, severe heart disease, severe hypotension, a severe breathing disorder...
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