A RARE CASE REPORT ON MYXOEDEMA COMA

Authors

  • SHANTHI B Department of Biochemistry, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
  • MARY CHANDRIKA A Department of Biochemistry, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.

DOI:

https://doi.org/10.22159/ajpcr.2021.v14i3.32401

Keywords:

Myxoedema coma, Hypothyroidism, Hyponatremia

Abstract

Myxoedema coma is a sporadic life-threatening complication of severe hypothyroidism with high mortality. Altered mental status and hypothermia are the main symptoms of myxoedema coma. Apart from that, hypoxia, bradycardia, hypotension, anemia, and hyponatremia would be present. Few patients present comatose with severe myxoedema. Presenting coma may mislead the diagnosis of this condition. A female patient presented with fever, breathlessness, and disorientation was admitted. First diagnosed to have electrolyte imbalance and treatment was started accordingly. The patient did not show much of an improvement, and it took a day to identify the presence of severe hypothyroidism. Treating hypothyroidism resulted in an advance in the patient condition. Patients’ previous history of hypothyroidism was not informed during admission. It is always tough to diagnose myxoedema coma when the patients’ previous history of hypothyroidism is unknown. Hence, it is still essential to have hypothyroidism in mind while treating patients with comatose. This case has been reported to alert physicians in diagnosing myxoedema coma patients and to proceed with the treatment at the earliest.

References

Titinalli JE, Kelen GD, Stapczynski JS. Hypothyroidism and myxedema coma. In: Seils A, Fernando N, Watt M, editors. Emergency Medicine; A Comprehensive Study Guide. 6th ed. New York: McGraw-Hills Inc.; 2004. p. 1313-5.

Wall CR. Myxoedema coma: Diagnosis and treatment. Am Fam Physician 2000;62:2485-90.

Fliers E, Wiersinga WM. Myxoedema coma. Rev Endocr Metab Disord 2003;4:137-41.

Kwaku MP, Burman KD. Myxoedema coma. J Intensive Care Med 2007;22:224-31.

Klubo-Gwiezdzinska J, Wartofsky L. Thyroid emergencies. Med Clin North Am 2012;96:385-403.

Elena C. Myxoedema Coma or Crisis; 2014. Available from: http:// www.emedicine.medscape.com/ article/123577-overview. [Last accessed on 2015 May 04].

Rosen M. Hypothyroidism. In: Marx J, editor. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, MO: Mosby Inc.; 2002. p. 1774-9.

Available from: http://www.misc.medscape.com/pi/iphone/ medscapeapp/html/A123577-business.html.

Shenoy MM, Goldman JM. Hypothyroid cardiomyopathy: Echocardiographic documentation of reversibility. Am J Med Sci 1987;294:1-9.

Rodríguez I, Fluiters E, Pérez-Méndez LF, Luna R, Páramo C,GarcíaMayor RV. Factors associated with mortality of patients with myxoedema coma: Prospective study in 11 cases treated in a single institution. J Endocrinol 2004;180:347-50.

Beynon J, Akhtar S, Kearney T. Predictors of outcome in myxoedema coma. Crit Care 2008;12:111.

Holvey DN, Goodner CJ, Nicoloff JT, Dowling JT. Treatment of myxedema coma with intravenous thyroxine. Arch Intern Med 1964;113:89-96.

Gupta G, Sharma P, Kumar P, Sharma R. Scope of inflammatory markers in subclinical hypothyroidism. Asian J Pharm Clin Res 2015;8:24-7.

Gupta G, Sharma P, Kumar P, Sharma R. Cardiovascular risk in patients with mild to severe subclinical hypothyroidism. Asian J Pharm Clin Res 2016;9:183-5.

Published

2021-03-07

How to Cite

B, S., and M. CHANDRIKA A. “A RARE CASE REPORT ON MYXOEDEMA COMA”. Asian Journal of Pharmaceutical and Clinical Research, vol. 14, no. 3, Mar. 2021, pp. 1-3, doi:10.22159/ajpcr.2021.v14i3.32401.

Issue

Section

Case Study(s)