Mixedema coma. A case reported
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Keywords
myxedema coma, hypothyroidism
Abstract
Myxedema coma is a life-threatening condition; it is a complication of untreated hypothyroidism and an endocrine emergency. Most patients are elderly women with a previous history of long-standing hypothyroidism which presents during the winter. The myxedema coma has an insidious onset and it is very rare; its recognition can be quite difficult. Once suspected, treatment can be lifesaving and should be start promptly in anticipation of confirmation of the diagnosis by laboratory test. The mortality rate is high. I presented a case of an old woman with myxedema coma with an undiagnosed hypothyroidism, with altered mental status, normal temperature, pneumonia, hyponatremia and high level of creatine phosphokinase, who presented in the emergency room.
References
Wartofsky L. Myxedema coma. Endocrinol Metab Clin N Am 2006;35:687-698.
Fliers E, Wiersinga WM. Myxedema coma. Rev Endocrine Metab Dis 2003;4:137-141.
Sarlis NJ, Gourgiotis L. Thyroid emergencies. Rev Endocrine Metab Dis 2003;4:129-136.
Tews MC, Shah SM, Gossain VV. Hypothyroidism: mimicker of common complaints. Emerg Med Clin N Am 2005;23:649-667.
Wall CR. Myxedema coma: diagnosis and treatment. Am Fam Phys 2000;62:2485-2490.
Mintzer MJ. Hypothyroidism and hyperthyroidism in the elderly. J Fla Med Assoc 1992;79:231-235.
Robuschi G, Safran M, Braverman LE, Gnudi A, Roti E. Hypothyroidism in the elderly. Endocr Rev 1987;8:142-153.
Wartofsky L. Myxedema coma. En: Braverman LE, Utiger RD, editores. Werner & Ingbar’s The Thyroid. A fundamental and clinical text. Phila-delphia, PA: Lippincott Williams & Wilkins; 2000. p. 843-847.
Nicoloff TT. Thyroid storm and myxedema coma. Med Clin N Am 1985;69:1005-1017.
Myers L, Hais J. Myxedema coma. Crit Care Clin 1991;7:43-56.
Zwillich CW, Pierson DJ, Hofeldt FD, Lufkin EG, Weil JV. Ventilatory control in myxedema and hypothyroidism. N Engl J Med 1975;292:662-665.
Yamamoto T. Delayed respiratory failure during the treatment of myxedema coma. Endocrinol Jpn 1984;31:769-775