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Myxedema coma

Akiteru Takamura, Ryusho Sangen, Yoshiki Furumura, Daisuke Usuda, Yuji Kasamaki, Tsugiyasu Kanda
Myxedema coma, caused by severe lack of thyroid hormone, is characterized by deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. We describe an 84-year-old woman who presented with renal failure and new onset severe hypothyroidism leading to challenges in the recognition of myxedema coma.
April 2017: Clinical Case Reports
Yosuke Ono, Sachiko Ono, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Yuji Tanaka
BACKGROUND: Myxedema coma is a life-threatening and emergency presentation of hypothyroidism. However, the clinical features and outcomes of this condition have been poorly defined because of its rarity. METHODS: We conducted a retrospective observational study of patients diagnosed with myxedema coma from July 2010 through March 2013 using a national inpatient database in Japan. We investigated characteristics, comorbidities, treatments, and in-hospital mortality of patients with myxedema coma...
March 2017: Journal of Epidemiology
Matthew M Mavroson, Nirav Patel, Eleonora Akker
Myxedema psychosis is uncommon in patients with primary hypothyroidism. Most often, this disease state can be found in patients with Hashimoto thyroiditis or after total thyroidectomy. Chronic hypothyroidism can lead to an insidious onset of psychiatric symptoms in patients, such as dementia, delirium, psychosis, hallucinations, and coma. A 31-year-old man with an unremarkable medical history was brought to the psychiatric emergency department for new-onset aggression, paranoid behavior, and hallucinations for 4 days...
January 1, 2017: Journal of the American Osteopathic Association
Pratik Patel, Mikhael Bekkerman, Cristina Varallo-Rodriguez, Rajendra Rampersaud
Hypothyroidism is a prevalent condition in the general population that is treatable with appropriately dosed thyroid hormone replacement medication. Infrequently, patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism. Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. Here, we present the case of a woman we diagnosed with an uncharacteristic expression of myxedema coma and nonconvulsive seizure complicated by a right middle cerebral artery infarct...
2016: Case Reports in Critical Care
Chia-I Shen, Hsu-Ching Huang, Yi-Chen Yeh, Chao-Hua Chiu
No abstract text is available yet for this article.
November 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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
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