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Myxedema coma

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https://www.readbyqxmd.com/read/29147476/sudden-cardiac-arrest-as-a-rare-presentation-of-myxedema-coma-case-report
#1
Divya Salhan, Deepak Sapkota, Prakash Verma, Saroj Kandel, Omar Abdulfattah, Antony Lixon, Deribe Zwenge, Frances Schmidt
Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29093409/myasthenic-crisis-complicated-with-myxedema-positive-for-both-anti-acetylcholine-receptor-and-anti-muscle-specific-tyrosine-kinase-antibodies-a-case-report
#2
Kazuhiro Horiuchi, Azusa Nagai, Masahiro Wakita, Shotaro Ito, Kei Takamura, Hideki Houzen
We herein report the case of myasthenic crisis occurring in a 51-year-old man. He had experienced ptosis, increased body weight with edema, and fatigue with dyspnea. He presented at our emergency department with disturbed consciousness. He was originally diagnosed with myxedema coma, and he required artificial respiration. Because his weakness persisted and he was positive for anti-acetylcholine receptor antibodies and anti-muscle-specific tyrosine kinase antibodies, we diagnosed myasthenic crisis after various examinations...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29026577/split-high-dose-oral-levothyroxine-treatment-as-a-successful-therapy-option-in-myxedema-coma
#3
Suranut Charoensri, Chutintorn Sriphrapradang, Hataikarn Nimitphong
High-dose intravenous thyroxine (T4) is the preferable treatment for myxedema coma. We describe the clinical course of a 69-year-old man who presented with myxedema coma and received oral levothyroxine (LT4) therapy (1 mg) in a split dose. This suggests split high-dose oral LT4 as a therapeutic option in myxedema coma.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28939923/-thyroid-emergencies-thyroid-storm-and-myxedema-coma
#4
REVIEW
C Spitzweg, M Reincke, R Gärtner
Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction...
October 2017: Der Internist
https://www.readbyqxmd.com/read/28825577/-myxedema-coma
#5
Leonardo F L Rizzo, Daniela L Mana, Oscar D Bruno, Leonard Wartofsky
Hypothyroidism is a frequently diagnosed and simply treated disease. If not recognised, however, in time it may develop into the most severe manifestation of hypothyroidism known as myxedema coma. The term "myxedema coma" is generally seen as misleading since most patients do not initially present in a coma. The typical progression is lethargy evolving into stupor and, eventually, into coma with respiratory failure and hypothermia. It mainly affects elderly women, often occurring in winter and is relatively rare...
2017: Medicina
https://www.readbyqxmd.com/read/28799309/thyroid-emergencies-new-insight-into-old-problems
#6
Ghan Shyam Pangtey, Udismita Baruah, Manash P Baruah, Sahil Bhagat
Thyroid emergencies are major life-threatening endocrine conditions associated with life-threatening disorders resulting from either severe deficiency or excess of thyroid hormones. Deficiency of thyroid hormones may present as myxedema coma whereas excessive hormone production can present as life threatening thyrotoxic storm. The diagnosis of both requires a high index of clinical suspicion. Thyroid storm, in spite of accurate diagnosis, continues to have high fatality, whereas myxedema management has markedly improved with advancement in intensive care facility...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28670061/thoracentesis-reverting-cardiac-tamponade-physiology-in-a-patient-with-myxedema-coma-and-large-pleural-effusion
#7
Monia E Werlang, Mario R Pimentel, Jose L Diaz-Gomez
A large pleural effusion causing cardiac tamponade physiology and severe hemodynamic compromise is an uncommon event. We report a case of a 53-year-old woman with severe hypothyroidism presenting with myxedema coma and refractory shock. Her hemodynamic status failed to respond to fluid resuscitation and vasopressors. A transthoracic echocardiogram and chest radiograph demonstrated a pericardial fluid accumulation associated with a large left-sided pleural effusion. Thoracostomy tube insertion resulted in prompt improvement of the patient's hemodynamic status...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28570329/endocrine-emergencies-with-neurologic-manifestations
#8
Makoto Ishii
PURPOSE OF REVIEW: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#9
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28396755/diagnosis-of-myxedema-coma-complicated-by-renal-failure-a-case-report
#10
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
https://www.readbyqxmd.com/read/28142035/clinical-characteristics-and-outcomes-of-myxedema-coma-analysis-of-a-national-inpatient-database-in-japan
#11
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
https://www.readbyqxmd.com/read/28055088/myxedema-psychosis-in-a-patient-with-undiagnosed-hashimoto-thyroiditis
#12
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
https://www.readbyqxmd.com/read/27872766/an-atypical-case-of-myxedema-coma-with-concomitant-nonconvulsive-seizure
#13
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
https://www.readbyqxmd.com/read/27823924/impending-myxedema-coma-as-the-initial-presentation-of-lung-cancer
#14
Chia-I Shen, Hsu-Ching Huang, Yi-Chen Yeh, Chao-Hua Chiu
No abstract text is available yet for this article.
June 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27631398/myxedema-coma-secondary-to-central-hypothyroidism-a-rare-but-real-cause-of-altered-mental-status-in-pediatrics
#15
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...
2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27598067/thyroid-emergencies
#16
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
https://www.readbyqxmd.com/read/27583414/morbidity-and-mortality-risks-of-premature-enteral-nutrition-during-the-recovery-of-myxedema-coma-a-response-to-the-article-entitled-pediatric-patient-with-altered-mental-status-and-hypoxemia
#17
LETTER
https://www.readbyqxmd.com/read/27050737/pediatric-patient-with-altered-mental-status-and-hypoxemia-case-report
#18
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.
July 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/26924647/a-rabbit-model-of-fatal-hypothyroidism-mimicking-myxedema-coma-established-by-microscopic-total-thyroidectomy
#19
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
https://www.readbyqxmd.com/read/26908108/precision-medicine-comes-to-thyroidology
#20
REVIEW
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
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