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[Thyroid emergencies : Thyroid storm and myxedema coma].

C Spitzweg1, M Reincke2, R Gärtner2

  • 1Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland. christine.spitzweg@med.uni-muenchen.de.

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Summary
This summary is machine-generated.

Thyroid emergencies, including thyroid storm and myxedema coma, are rare but life-threatening endocrine crises. Early clinical diagnosis and prompt, multimodal treatment are crucial for optimizing patient survival in these critical conditions.

Keywords:
Antithyroid drugsCritical care, supportiveGlucocorticoidsHormone replacement therapyL-ThyroxineThyroid hormones

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Area of Science:

  • Endocrinology
  • Emergency Medicine

Background:

  • Thyroid emergencies are rare, life-threatening endocrine conditions.
  • They arise from decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma).
  • These conditions often develop from long-standing, undiagnosed, or untreated hyperthyroidism or hypothyroidism, precipitated by acute stress.

Purpose of the Study:

  • To summarize the clinical presentation, diagnosis, and management of thyroid emergencies.
  • To highlight the importance of early clinical recognition and prompt multimodal therapy.

Main Methods:

  • Review of cardinal clinical features for thyroid storm and myxedema coma.
  • Discussion of diagnostic criteria, emphasizing clinical assessment over hormone levels.
  • Outline of therapeutic strategies, including critical care, hormone modulation, and supportive measures.

Main Results:

  • Thyroid storm presents with hyperthermia, tachycardia, and central nervous system dysfunction.
  • Myxedema coma is characterized by hypothermia, altered mental status, and hypoventilation.
  • Diagnosis for both is primarily clinical, as hormone levels do not distinguish emergency from uncomplicated states.

Conclusions:

  • Optimal survival in thyroid emergencies depends on early clinical diagnosis.
  • Prompt initiation of multimodal therapy, including supportive care and addressing precipitating factors, is essential.