Myxedema coma

Myxedema coma
Synonyms	Myxedema crisis
Pronounce	N/A
Specialty	N/A
Symptoms	Hypothermia, hypotension, bradycardia, hypoventilation, altered mental status
Complications	Respiratory failure, heart failure, coma
Onset	Gradual worsening of hypothyroidism
Duration	Acute
Types	N/A
Causes	Severe hypothyroidism, often precipitated by infection, cold exposure, or medication
Risks	Elderly, female, history of thyroid disease
Diagnosis	Clinical evaluation, supported by thyroid function tests
Differential diagnosis	Sepsis, adrenal insufficiency, hypoglycemia, stroke
Prevention	N/A
Treatment	Intravenous thyroid hormone replacement, supportive care
Medication	Levothyroxine, liothyronine
Prognosis	High mortality if untreated, improved with prompt treatment
Frequency	Rare
Deaths	N/A

Myxedema Coma is a severe, life-threatening form of hypothyroidism that is characterized by mental and physical sluggishness. It is a medical emergency that requires immediate attention.

Signs and Symptoms

The signs and symptoms of myxedema coma can vary widely, depending on the severity of the hypothyroidism. Some common signs and symptoms include:

• Extreme fatigue
• Cold intolerance
• Drowsiness
• Unintentional weight gain
• Dry skin
• Hair loss
• Slow heart rate
• Constipation
• Depression
• Muscle aches and stiffness
• Swelling of the hands, feet, and face

Causes

Myxedema coma is usually caused by long-term, untreated hypothyroidism. Other potential causes can include:

• Infections
• Certain medications
• Stroke
• Trauma
• Surgery
• Heart failure
• Respiratory failure

Diagnosis

Diagnosis of myxedema coma is based on the patient's clinical history, physical examination, and laboratory tests. The most definitive test is a blood test to measure the levels of thyroid hormones (thyroxine (T4) and triiodothyronine (T3)) and thyroid-stimulating hormone (TSH).

Treatment

Treatment of myxedema coma typically involves immediate hospitalization and intensive care. Treatment may include:

• Hormone replacement therapy
• Supportive care (such as warming blankets and intravenous fluids)
• Treatment of underlying causes or triggers

Prognosis

The prognosis for myxedema coma is generally poor, with a high mortality rate. However, with prompt and aggressive treatment, it is possible for patients to recover.

See Also

• Hypothyroidism
• Thyroid
• Thyroid hormones
• Thyroid-stimulating hormone