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Myxedema coma

Michael D Thompson, Rohan K Henry
BACKGROUND: Myxedema coma (MC), a medical emergency defined as severe hypothyroidism leading to altered mental status, is more common in older women with hypothyroidism. METHODS/RESULTS: A 7-year-old Caucasian male with chromosome 1q deletion presented with altered mental status preceded by milestone regression. His presenting labs results were: thyroid-stimulating hormone (TSH) 0.501 μIU/ml and free thyroxine (T4) <0.5 ng/dl. His morning cortisol level was 8...
September 16, 2016: Hormone Research in Pædiatrics
Angela M Leung
Myxedema coma and thyroid storm are thyroid emergencies associated with increased mortality. Prompt recognition of these states-which represent the severe, life-threatening conditions of extremely reduced or elevated circulating thyroid hormone concentrations, respectively-is necessary to initiate treatment. Management of myxedema coma and thyroid storm requires both medical and supportive therapies and should be treated in an intensive care unit setting.
September 2016: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Jeremy M Root, Marcela Vargas, Luigi R Garibaldi, Richard A Saladino
Childhood cases of myxedema coma are extremely rare. We report a case of a 5-year-old girl transferred to a tertiary care pediatric emergency department with hypoxemia and altered mental status and diagnosed with severe hypothyroidism and myxedema coma in the setting of acute influenza infection. Although it is rare, myxedema coma must remain in the differential diagnosis for altered mental status and organ dysfunction in the pediatric population.
April 5, 2016: Pediatric Emergency Care
Yosuke Ono, Masanori Fujita, Sachiko Ono, Sho Ogata, Shoichi Tachibana, Yuji Tanaka
Myxedema coma (MC) is a life-threatening endocrine crisis caused by severe hypothyroidism. However, validated diagnostic criteria and treatment guidelines for MC have not been established owing to its rarity. Therefore, a valid animal model is required to investigate the pathologic and therapeutic aspects of MC. The aim of the present study was to establish an animal model of MC induced by total thyroidectomy. We utilized 14 male New Zealand White rabbits anesthetized via intramuscular ketamine and xylazine administration...
June 30, 2016: Endocrine Journal
Paul W Ladenson
The broad spectrum of thyroid disease severity--from subclinical hypothyroidism to myxedema coma, subclinical thyrotoxicosis to thyroid storm, and microscopic papillary to anaplastic cancers--has always demanded that clinicians individualize their management of thyroid patients. Deepening knowledge of thyroid pathophysiology along with advances in diagnostic, prognostic, and therapeutic technologies applicable to thyroid diseases position this field to ride the wave of precision medicine in the decade ahead...
March 2016: Journal of Clinical Endocrinology and Metabolism
Siddharth Dixit, Manoj Kumar Dutta, Mayank Namdeo
Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS contributing to diagnostic problem and treatment delay...
May 2015: Journal of Clinical and Diagnostic Research: JCDR
Thomas Kuhl
No abstract text is available yet for this article.
April 2015: Deutsche Medizinische Wochenschrift
Yien V Chiong, Elaine Bammerlin, Cary N Mariash
Myxedema coma, a rare entity, with a reported 25%-65% mortality had no objective criteria for making the diagnosis when we began our study. We developed an objective screening tool for myxedema coma to more easily identify patients and examine the best treatment method in future prospective studies to reduce the mortality of this entity. We conducted a retrospective chart review to find all patients aged ≥18 years admitted with myxedema coma from January 1, 2005 through June 13, 2010 at Indiana University Health Methodist Hospital...
September 2015: Translational Research: the Journal of Laboratory and Clinical Medicine
Subhankar Chakraborty, Julie Fedderson, Jeremiah J Gums, Ashley Toole
No abstract text is available yet for this article.
December 22, 2014: Archives of Medical Science: AMS
Pilar Muñoz B, Víctor Rossel M
We report a 77-year-old female patient who was admitted to the Emergency Department with impairment of consciousness, hypotension, bradycardia and hypothermia. She required endotracheal intubation and transfer to Intensive Care Unit (ICU). Computed tomography of the brain showed no lesions. Electrocardiogram showed abnormalities suggestive of severe hypothermia (bradycardia, marked elevation of J point associated with ST depression, a negative T wave in V2 to V6 and prolongation of QTc), which was confirmed with a pulmonary artery catheter...
September 2014: Revista Médica de Chile
Jan-Shun Chang, Tien-Chun Chang
Both severe thyrotoxicosis and hypothyroidism may affect brain function and cause a change in consciousness, as seen with a thyroid storm or myxedema coma. However, encephalopathy may also develop in patients with autoimmune thyroid diseases independent of actual thyroid function level, and this is known as Hashimoto's encephalopathy. Although most patients are found to have Hashimoto's thyroiditis, less frequently they have Graves' disease. Clinical manifestations include epilepsy, disturbance of consciousness, cognitive impairment, memory loss, myoclonus, hallucinations, stroke-like episodes, tremor, involuntary movements, language impairment, and gait impairment...
November 2014: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Abdulla Majid-Moosa, Jeffery Schussler, Adam Mora
Critical Care Student/Resident Case Report Posters IIISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Myxedema Crisis (MC), a rare life-threatening complication of hypothyroidism, is associated with cardiac manifestations. Presented is a case of cardiac tamponade combined with cardiomyopathy.CASE PRESENTATION: A 57-year-old woman presented to the emergency department with mid-epigastric pain denying other gastrointestinal symptoms...
October 1, 2014: Chest
Vikas Sharma, Papori Borah, Lakshya J Basumatary, Marami Das, Munindra Goswami, Ashok K Kayal
INTRODUCTION: MAJOR CATEGORIES OF ENDOCRINE MYOPATHY INCLUDE THOSE ASSOCIATED WITH: Adrenal dysfunction (as in Cushing's disease or steroid myopathy); thyroid dysfunction (as in myxedema coma or thyrotoxic myopathy); vitamin D deficiency; parathyroid dysfunction; and pituitary dysfunction. Steroid myopathy is the most common endocrine myopathy. OBJECTIVE: To study the etiology, varied presentations, and outcome after therapy of patients with endocrine myopathies...
July 2014: Annals of Indian Academy of Neurology
Gaurav Kakked, Nikita Bhatt, Jitendra Lakhani, Sanjay Prakash
BACKGROUND: Neurological dysfunction is an important consequence of hypothyroidism. Some of the neurologic manifestations of hypothyroidism include somnolence, lethargy, impaired memory and concentration, depression and entrapment neuropathy. Rarer but reversible neurological manifestations include cerebellar ataxia, psychosis, dementia and myxedema coma. PURPOSE: The aim of the present study was to evaluate the usefulness of the blink reflex as a method for obtaining an early diagnosis of central nervous system dysfunction in hypothyroid patients who do not have signs or symptoms of nervous system dysfunction...
July 2013: Annals of Neurosciences
Shahnaz Ahmad Mir, Arshad Iqbal Wani, Shariq Rashid Masoodi, Mir Iftikhar Bashir, Nadeem Ahmad
UNLABELLED: While thyroid dysfunction is a frequent complication of lithium treatment, myxedema crisis is a rare occurrence with a handful of cases described. Here, we describe a patient receiving lithium for about a decade for bipolar disorder, who presented with myxedema crisis and lithium toxicity. In this patient, myxedema crisis was likely precipitated by lithium toxicity and community acquired pneumonia. The effects of lithium on thyroid are briefly reviewed. OBJECTIVE: To describe an elderly male who was diagnosed with myxedema crisis and lithium toxicity...
December 2013: Indian Journal of Endocrinology and Metabolism
Sarah B Dubbs, Ryan Spangler
Hypothyroidism is a very common, yet often overlooked disease. It can have a myriad of signs and symptoms, and is often nonspecific. Identification requires analysis of thyroid hormones circulating in the bloodstream, and treatment is simply replacement with exogenous hormone, usually levothyroxine (Synthroid). The deadly manifestation of hypothyroidism is myxedema coma. Similarly nonspecific and underrecognized, treatment with exogenous hormone is necessary to decrease the high mortality rate.
May 2014: Emergency Medicine Clinics of North America
Dhara Chaudhari, Venkat Gangadharan, Terry Forrest
Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.
February 2014: Tennessee Medicine: Journal of the Tennessee Medical Association
Robert James, Jessie James, Amarjit Singh Vij, Kamaljeet Kaur Vij
Hypothyroidism is a commonly diagnosed endocrine disorder in medicine. Hyponatraemia is reported in up to 10% of hypothyroid patients, although it is usually mild and rarely causes symptoms. Myxoedema coma is a rare manifestation of hypothyroidism and it can be lethal if it goes undiagnosed and untreated. Our patient presented with an acute manifestation of probable long-standing, but undiagnosed, hypothyroidism. She was asymptomatic but when subjected to surgery (identifiable stress factor) it precipitated as myxoedema coma...
2014: BMJ Case Reports
Geanina Popoveniuc, Tanu Chandra, Anchal Sud, Meeta Sharma, Marc R Blackman, Kenneth D Burman, Mihriye Mete, Sameer Desale, Leonard Wartofsky
OBJECTIVE: To develop diagnostic criteria for myxedema coma (MC), a decompensated state of extreme hypothyroidism with a high mortality rate if untreated, in order to facilitate its early recognition and treatment. METHODS: The frequencies of characteristics associated with MC were assessed retrospectively in patients from our institutions in order to derive a semiquantitative diagnostic point scale that was further applied on selected patients whose data were retrieved from the literature...
August 2014: Endocrine Practice
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