449 results match your criteria Hypothyroidism and Myxedema Coma

Neurological Complications of Endocrine Emergencies.

Curr Neurol Neurosci Rep 2021 03 11;21(5):21. Epub 2021 Mar 11.

Department of Neurology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.

Purpose Of Review: Endocrine disorders are the result of insufficient or excessive hormonal production. The clinical course is long, and the manifestations are nonspecific due to the systemic effect of hormones across many organs and systems including the nervous system. This is a narrative review of the recent evidence of the diagnosis and treatment approach of these medical and neurological emergencies. Read More

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An Unusual Presentation of ST Elevation Myocardial Infarction Complicated with Cardiogenic Shock Due to Myxedema Coma: A Case Report.

Am J Case Rep 2021 Mar 10;22:e929573. Epub 2021 Mar 10.

Department of Cardiology, United Health Services Hospitals, Wilson Regional Medical Center, Johnson City, NY, USA.

BACKGROUND Myxedema coma is an endocrine emergency with a high mortality rate, defined as a severe hypothyroidism leading to hypotension, bradycardia, decreased mental status, hyponatremia, hypoglycemia, and cardiogenic shock. Although hypothyroidism and cardiac disease has been interlinked, ST elevation myocardial infarction in the setting of myxedema coma have not been reported previously. CASE REPORT We report the case of a 70-year-old man who presented to the Emergency Department with chest pain and confusion. Read More

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[A case of elderly myxedema coma patient with end-stage renal failure].

Nihon Ronen Igakkai Zasshi 2021 ;58(1):152-157

Department of Endocrinology & Metabolism, Takagi Hospital.

Case: 84-year-old woman had been diagnosed hypothyroidism before, but she did not take tablets of thyroid hormone prescribed. Anorexia and decreased consciousness level were discovered by workers of the facility. Her family doctor found thyroid function abnormality as a cause, and she was introduced to our hospital to treat because the whole body condition was bad. Read More

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February 2021

Clinical manifestation and images of a patient having cardiovascular involvement in myxoedema coma.

Med J Armed Forces India 2021 Jan 15;77(1):92-95. Epub 2019 Apr 15.

Junior Resident (Medicine), Command Hospital (Central Command), Lucknow Cantt, India.

Myxoedema coma is an endocrine emergency characterised by diminished sensorium associated with features of severe hypothyroidism. The disease carries a high mortality of 30%-60 %. The cardiac manifestation of the disease consists of bradycardia, hypotension, pericardial effusion and certain echocardiographic changes such as heart block and features of hypothermia. Read More

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January 2021

Congenital hypothyroidism presenting as myxedema coma in a teenager.

Am J Emerg Med 2021 Jan 13. Epub 2021 Jan 13.

Division of Pediatric Emergency Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.

Congenital hypothyroidism is rare and is screened for in the United States during the newborn period in order to prevent a treatable cognitive delay. Myxedema coma is a complication due to severe hypothyroidism resulting from failure of homeostatic processes, causing altered mental status, generalized edema, and vital sign abnormalities. Treatment of myxedema coma consists of supportive care and hormone replacement. Read More

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January 2021

Legions of Presentations of Myxedema Coma: A Case Series from a Tertiary Hospital in India.

J ASEAN Fed Endocr Soc 2020 29;35(2):233-237. Epub 2020 Nov 29.

Department of Internal Medicine, KPC Medical College and Hospital, West Bengal University of Health Sciences, Kolkata, India.

Myxedema coma is associated with decreased mental status and hyponatremia among patients with diagnosed or undiagnosed hypothyroidism. The diagnosis is challenging in the absence of universally accepted diagnostic criteria, but should be considered as a differential even in cases with competing established diagnoses. All patients should receive intensive care level treatment. Read More

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November 2020

Myxedema Coma: A Life-Threatening Condition in Patients Using Pembrolizumab.

Case Rep Endocrinol 2020 22;2020:8855943. Epub 2020 Oct 22.

Berkshire Medical Center, 725 North Street, Pittsfield, MA 01201, USA.

The advent of immune checkpoint inhibitors has significantly improved the prognosis of patients with advanced malignancies. As we begin to understand these medications, multiple immune-related adverse effects (irAEs) have been found with these drugs, including endocrinopathies. Understanding the treatment-related adverse events of these medications is critical for clinical practice. Read More

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October 2020

Myxedema Coma: A Forgotten Medical Emergency With a Precipitous Onset.

Cureus 2020 Sep 16;12(9):e10478. Epub 2020 Sep 16.

Internal Medicine, Campbell University School of Osteopathic Medicine, Buies Creek, USA.

Myxedema coma is a rare life-threatening disorder characterized by severe hypothyroidism leading to multiorgan failure and even death. This case also reminds clinicians that the misnomer "coma" is misleading, and the patient can present with less severe symptoms. We present a case of a 72-year-old female with a history of primary hypothyroidism who presented to the emergency department with progressively worsening confusion for three days. Read More

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September 2020

Decompensated hypothyroidism: A review for the emergency clinician.

Am J Emerg Med 2021 01 30;39:207-212. Epub 2020 Sep 30.

Department of Emergency, Medicine Brooke Army Medical Center, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States. Electronic address:

Background: Decompensated hypothyroidism, formerly known as myxedema coma, is an endocrine emergency that commonly presents with altered mental status, as well as hypothermia and depressed vital signs. The condition is often caused by an inciting event, which may lead to significant delays in the diagnosis and management of this disease. Although the incidence is low, this disease is associated with significant morbidity and mortality. Read More

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January 2021

Amiodarone-Associated Myxedema Coma.

Am J Case Rep 2020 Oct 10;21:e926757. Epub 2020 Oct 10.

Department of Internal Medicine, Reading Hospital/Tower Health, Reading, PA, USA.

BACKGROUND Myxedema coma is an uncommon severe thyroid disorder that is fatal in 25-60% of cases. Although the differential diagnosis for altered mental status is extensive, including many more common causes such as infection, medication changes, electrolyte abnormalities, and exacerbation of chronic illnesses, profound hypothyroidism is an uncommon cause that can be overlooked. CASE REPORT We describe the case of a 71-year-old man on long-term amiodarone treatment for atrial fibrillation who presented with altered mental status initially ascribed to uremia, hyponatremia, and pneumonia. Read More

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October 2020

Thyroid Disease Spectrum in the Emergency Department.

Cureus 2020 Aug 28;12(8):e10100. Epub 2020 Aug 28.

Internal Medicine, Hospital Senhora da Oliveira Guimarães, Guimarães, PRT.

We present two cases of thyroid hormone alterations revealing clinical emergencies that require early diagnosis and prompt treatment. The first patient, a 56-year-old woman, presented in the emergency room with psychomotor agitation, disorientation and headache. She was very agitated, incapable of standing still, looked very thin, feverish, tachycardic and presented no alteration at neurological examination with negative meningeal signs. Read More

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Sudden Cardiac Arrest in a Patient With Myxedema Coma and COVID-19.

J Endocr Soc 2020 Oct 28;4(10):bvaa130. Epub 2020 Aug 28.

Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California.

SARS-CoV-2 infection is associated with significant lung and cardiac morbidity but there is a limited understanding of the endocrine manifestations of coronavirus disease 2019 (COVID-19). Although thyrotoxicosis due to subacute thyroiditis has been reported in COVID-19, it is unknown whether SARS-CoV-2 infection can also lead to decompensated hypothyroidism. We present the first case of myxedema coma (MC) in COVID-19 and we discuss how SARS-CoV-2 may have precipitated multiorgan damage and sudden cardiac arrest in our patient. Read More

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October 2020

A Case of Refractory Myxedema Coma.

Cureus 2020 Aug 14;12(8):e9737. Epub 2020 Aug 14.

Endocrinology, Mount Sinai Medical Center/Elmhurst Hospital Center, New York City, USA.

We present a case of myxedema coma refractory to traditional treatments. Morbidity and mortality from myxedema coma are frequently due to a missed or delayed diagnosis. It tends to respond very well to intravenous levothyroxine replenishment as long as this treatment is initiated early. Read More

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Amiodarone-Induced Myxedema Coma.

Cureus 2020 Aug 20;12(8):e9902. Epub 2020 Aug 20.

Department of Emergency Medicine, Grandview Medical Center, Dayton, USA.

Amiodarone is a class III antiarrhythmic drug often used to treat supraventricular and ventricular arrhythmias with high efficacy. Amiodarone is associated with thyroid dysfunction, which can lead to myxedema coma (MC) in undiagnosed cases. Amiodarone-induced MC is a life-threatening condition that presents a complex diagnostic challenge to emergency physicians. Read More

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Idiopathic Granulomatous Mastitis Presenting in a Patient With Hypothyroidism and Recent Hospitalization for Myxedema Coma: A Rare Case Report and Review of Literature.

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620949325

Florida State University, Sarasota, FL, USA.

Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast. Clinical features may include painful breasts, erythema, subcutaneous nodules, and ulcerative lesions. It can mimic various other breast pathologies, and it is a diagnosis of exclusion after infection, malignancy, and other inflammatory conditions have been ruled out. Read More

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Reversible bradycardia secondary to myxedema coma: case-report.

Rev Cardiovasc Med 2020 Jun;21(2):297-301

Division of Cardiology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA.

Myxedema coma occurs mostly in patients with long-standing untreated or undertreated hypothyroidism. Bradycardia is a well-known cardiac manifestation for myxedema coma; however, not all bradycardia with hypothyroidism are sinus bradycardia. Sick sinus syndrome is a group of arrhythmias caused by the malfunction of the natural pacemaker of the heart. Read More

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Myxoedema Coma Masquerading as Acute Stroke.

Eur J Case Rep Intern Med 2020 22;7(7):001563. Epub 2020 Apr 22.

St Peter's Hospital, Lyne, Chertsey, Surrey, UK.

This report describes the management of a patient with myxoedema coma masquerading as an acute stroke (with or without 'cold sepsis'). Myxoedema coma is an endocrine emergency occurring when physiological adaptations to untreated hypothyroidism are overwhelmed by an acute precipitant. Even promptly treated, it has an associated mortality of up to 50%. Read More

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Ann Intern Med 2020 07;173(1):ITC1-ITC16

University of Colorado School of Medicine, Denver, Colorado (M.T.M.).

Hypothyroidism is a common condition in which the thyroid gland provides insufficient amounts of thyroid hormone for the needs of peripheral tissues. The most common cause in adults is chronic lymphocytic thyroiditis (Hashimoto thyroiditis), but there are many other causes. Because most of the clinical features of hypothyroidism are nonspecific, the diagnosis requires laboratory testing. Read More

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Enteric Fever Precipitating Myxedema Crisis.

Indian J Pediatr 2020 Oct 12;87(10):873-874. Epub 2020 May 12.

Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

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October 2020

Pericardial Effusion as an Initial Presentation of Panhypopituitarism.

Eur J Case Rep Intern Med 2020 24;7(4):001478. Epub 2020 Feb 24.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Pericardial effusion has a broad spectrum of clinical presentation, ranging from an incidental finding on imaging to a potentially fatal emergency such as pericardial tamponade, the most severe presentation. The authors present a case of a middle-aged male hospitalized due to shortness of breath. Initial work-up was positive for massive pericardial effusion with haemodynamic compromise. Read More

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February 2020

Anesthesia for Endocrine Emergencies.

Anesthesiol Clin 2020 Mar 2;38(1):149-163. Epub 2020 Jan 2.

Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Virginia Mason Medical Center, 1100 Ninth Avenue, B2-AN, Seattle, WA 98101, USA; Division of Critical Care Medicine, Virginia Mason Medical Center, 1100 Ninth Avenue, B2-AN, Seattle, WA 98101, USA. Electronic address:

Although endocrine emergencies are not common occurrences, their identification and careful perioperative management are of paramount importance for reduction of patient morbidity and mortality. The most common critical endocrine abnormalities are associated with functional tumors, such as pheochromocytomas, insulinomas, and carcinoid tumors, leading to carcinoid syndrome, abnormal thyroid function, or disturbances in the hypothalamus-pituitary-adrenal axis, causing adrenal insufficiency. This article aims to discuss the pathophysiology, diagnosis, and perioperative management of pheochromocytomas, hyperthyroidism, hypothyroidism, adrenal insufficiency, carcinoid disease, and insulinomas. Read More

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Myxedema Coma in a Pediatric Patient with Down Syndrome.

J Pediatr Intensive Care 2020 Mar 24;9(1):70-73. Epub 2019 Oct 24.

Department of Pediatrics, Pediatric Intensive Care Unit, Seth G.S. Medical College & KEM Hospital, Mumbai, Maharashtra, India.

Myxedema coma due to severe/long standing hypothyroidism is a known fatal endocrine emergency but is rare in children and unreported in pediatric Down syndrome. It mimics other conditions in the emergency room, making the diagnosis challenging. We present a 10-year-old-male child with global developmental delay and Down syndrome phenotype, admitted for altered sensorium subsequent to a febrile illness. Read More

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Diagnosis and treatment of hypothyroidism in old people : A new old challenge.

Wien Klin Wochenschr 2020 Mar 26;132(5-6):161-167. Epub 2019 Nov 26.

Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy.

Purpose: To review the diagnosis and the treatment of both subclinical and overt hypothyroidism in old people, which could represent a challenge for the clinicians.

Methods: Narrative literature review. An extensive literature search was performed using the databases of Scopus, Medline through PubMed, and Google Scholar from January 1975 to May 2019. Read More

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Myxedema coma: four patients diagnosed at the Internal Medicine Department of the Dr. Negrin University Hospital in Spain.

Pan Afr Med J 2019 3;34. Epub 2019 Sep 3.

Servicio de Medicina Interna, Hospital Universitario de Gran Canaria Dr Negrin, Spain.

Myxedema coma is a rare complication of hypothyroidism. Clinical examination may reveal hypotension, bradycardia, and hypothermia. Laboratory tests may show hyponatremia, lipid disorders, and elevations of creatine kinase, liver, and cardiac enzymes. Read More

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December 2019

Myxedema coma accompanied by sick sinus syndrome and hypoventilation: A case report.

J Gen Fam Med 2019 Sep 25;20(5):206-208. Epub 2019 Jun 25.

Department of General Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kitaku Japan.

Myxedema coma is an emergency presentation of hypothyroidism, and cardiopulmonary manifestations of the disease are related to a high mortality rate. We herein report a case of myxedema coma accompanied by sick sinus syndrome requiring temporary cardiac pacing and hypercapnic respiratory failure in an 87-year-old woman. This case is unique because both of the cardiac and pulmonary manifestations were reversible and successfully treated with thyroid hormone replacement. Read More

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September 2019

Myxedema Coma Complicated by Pancytopenia.

Case Rep Med 2019 14;2019:2320751. Epub 2019 Jul 14.

Kings County Hospital Center, Department of Pulmonary and Critical Care, Brooklyn, NY, USA.

Hypothyroidism is common, with an extreme manifestation of myxedema coma if untreated. Hematologic consequences of myxedema coma include mild leukopenia and anemia, rarely pancytopenia. We present a patient with typical symptoms of myxedema coma, but found to be pancytopenic, with sustained response to levothyroxine and blood transfusion for anemia. Read More

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Thyroid emergencies.

Pol Arch Intern Med 2019 08 25;129(7-8):526-534. Epub 2019 Jun 25.

Endocrinology Division, Department of Medicine, Georgetown University School of Medicine, Washington DC, United States

Myxedema coma and thyroid storm are among the most common endocrine emergencies presenting to general hospitals. Myxedema coma represents the most extreme, life‑threatening expression of severe hypothyroidism, with patients showing deteriorating mental status, hypothermia, and multiple organ system abnormalities. It typically appears in patients with preexisting hypothyroidism via a common pathway of respiratory decompensation with carbon dioxide narcosis leading to coma. Read More

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Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss: a case report.

BMC Endocr Disord 2019 May 22;19(1):52. Epub 2019 May 22.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.

Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. Read More

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