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[Hyponatremia and myxedamatous coma].

J Pasquier, H Rousset, M Sibille

    La Semaine Des Hopitaux : Organe Fonde Par L'Association D'Enseignement Medical Des Hopitaux De Paris
    |May 23, 1977
    PubMed
    Summary

    Myxedema coma can cause severe hyponatremia (low sodium). Thyroid hormone treatment rapidly resolved coma and hyponatremia, suggesting a renal origin for this metabolic disturbance.

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    Area of Science:

    • Endocrinology
    • Nephrology
    • Internal Medicine

    Background:

    • Myxedema coma, a severe manifestation of hypothyroidism, can present with life-threatening metabolic derangements.
    • Hyponatremia is a frequent complication of myxedema coma, necessitating careful diagnosis and management.

    Observation:

    • A case of coma due to peripheral myxedema with severe hyponatremia (111 mEq/L) and low urinary sodium is presented.
    • The patient's clinical and metabolic abnormalities resolved within ten days of thyroid hormone replacement therapy.

    Findings:

    • The study discusses the pathogenic mechanisms of hyponatremia in myxedema coma.
    • While adrenal origin is excluded, hypervasopressinism is considered, but the primary cause is identified as thyroxine-dependent hyponatremia of renal origin.

    Implications:

    • This case highlights the importance of recognizing and treating hyponatremia in myxedema coma.
    • Understanding the renal basis of thyroxine-dependent hyponatremia can guide therapeutic strategies in endocrine emergencies.

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