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Myxedema coma: a new look into an old crisis
Vivek Mathew1, Raiz Ahmad Misgar, Sujoy Ghosh
1Institute of Post-Graduate Medical Education & Research, Calcutta 700020, India.
Journal of Thyroid Research
|September 24, 2011
Summary
Myxedema crisis, a severe hypothyroidism complication, has high mortality. Early recognition and treatment, including thyroid hormone replacement, are crucial for survival and preventing complications.
Area of Science:
- Endocrinology
- Critical Care Medicine
Background:
- Myxedema crisis is a life-threatening decompensated hypothyroidism.
- High mortality rates are associated with myxedema crisis.
- Infections and medication non-adherence are key precipitating factors.
Purpose of the Study:
- To outline the clinical presentation, precipitating factors, and management of myxedema crisis.
- To identify predictors of mortality in myxedema crisis patients.
Main Methods:
- Retrospective review of myxedema crisis cases.
- Analysis of clinical features, precipitating factors, and outcomes.
- Identification of significant mortality predictors.
Main Results:
- Hypotension, bradycardia, need for ventilation, hypothermia, sepsis, low GCS, and high APACHE II/SOFA scores predict mortality.
- Thyroid hormone replacement, via nasogastric tube or orally, is effective.
- Arrhythmias and coagulation disorders are common.
Conclusions:
- Early diagnosis and prompt thyroid hormone replacement in an intensive care setting improve outcomes.
- Managing precipitating factors and ensuring medication adherence are vital for prevention.
- Risk stratification using clinical and scoring systems aids in managing severe cases.
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