Myxedema coma

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Myxedema coma
Classification and external resources
ICD-10 E03.5

Myxedema coma is a state of decompensated hypothyroidism. A person may have lab values identical to a "normal" hypothyroid state, but a stressful event (such as an infection, myocardial infarction or stroke) precipitates the myxedema coma state, usually in the elderly. Primary symptoms of myxedema coma are altered mental status and hypothermia. Hypoglycemia, hypotension, hyponatremia, hypercapnia, hypoxia, bradycardia, and hypoventilation may also occur.[1] Myxedema, although included in the name, is not necessarily seen in myxedema coma.[2]

Treatment[edit]

Mechanical ventilation if there is significant hypoxia.

Intravenous high doses of T4, T4 and T3, or T3. IV Levothyroxine (500-800 µg).However liothyronine is preferred due to its rapid onset of action.

Determine initial cortisol level, and administer corticosteroids (hydrocortisone at 5-10 mg/h).

Gradual warming with blankets; an external heating source should not be used.

Consider starting antibiotic prophylaxis until cultures come back, since infection is often the precipitating cause.[3]

References[edit]

  1. ^ "Myxedema Coma." UpToDate Online 15.2.
  2. ^ stepup to medicine
  3. ^ Myxedema coma / crisis http://emedicine.medscape.com/article/123577

External links[edit]