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Myxedema Coma or Crisis

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Thyroid emergencies.

Dorina Ylli, Joanna Klubo-Gwiezdzinska, Leonard Wartofsky,

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 ... Read more >>

(Polish archives of internal medicine)
[2019, 129(7-8):526-534]

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Hyperthyroidism.

Amanda R Doubleday, Rebecca S Sippel,

Hyperthyroidism is a condition where the thyroid gland produces and secretes inappropriately high amounts of thyroid hormone which can lead to thyrotoxicosis. The prevalence of hyperthyroidism in the United States is approximately 1.2%. There are many different causes of hyperthyroidism, and the most common causes include Graves' disease (GD), toxic ... Read more >>

Gland Surg (Gland surgery)
[2020, 9(1):124-135]

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

Ko Harada, Shuntaro Murakami, Kazuki Tokumasu, Yu Togawa, Fumio Otsuka,

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 ... Read more >>

J Gen Fam Med (Journal of general and family medicine)
[2019, 20(5):206-208]

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Myxedema Coma, Pancytopenia, and Hypocoagulopathy: A Rare Presentation of Sheehan's Syndrome.

Badari Mylliemngap, Satish Swain, Surabhi Vyas, Prabhat Kumar,

Indian J Endocrinol Metab (Indian journal of endocrinology and metabolism)
[2019, 23(2):268-269]

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Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care.

Richard Birtwhistle, Kate Morissette, James A Dickinson, Donna L Reynolds, Marc T Avey, Francesca Reyes Domingo, Rachel Rodin, Brett D Thombs, ,

CMAJ (CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne)
[2019, 191(46):E1274-E1280]

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Myxedema Coma in a Pediatric Patient with Down Syndrome.

Chhaya A Divecha, Milind S Tullu, Chandrahas T Deshmukh, Sunil Karande,

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 ... Read more >>

J Pediatr Intensive Care (Journal of Pediatric Intensive Care)
[2020, 9(1):70-73]

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

Antonio Maria Borzì, Antonio Biondi, Francesco Basile, Marco Vacante,

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. The ... Read more >>

Wien. Klin. Wochenschr. (Wiener Klinische Wochenschrift)
[2020, 132(5-6):161-167]

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Thyrotoxicosis factitia: a rare cause of junctional rhythm and cardiac arrest.

Sohaib Roomi, Waqas Ullah, Iqra Iqbal, Asrar Ahmad, Sameer Saleem, Zeeshan Sattar,

Thyrotoxicosis factitia is a hyperthyroid state due to the accidental or deliberate thyroxine ingestion. It can have many complications depending upon the organ involved. We present a case of a heavy built athlete presenting with cardiac arrest, who was found to be abused the thyroxine hormone for bodybuilding. Electrocardiogram (EKG) ... Read more >>

J Community Hosp Intern Med Perspect (Journal of community hospital internal medicine perspectives)
[2019, 9(3):258-263]

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

Noel Lorenzo Villalba, Abrar-Ahmad Zulfiqar, Vanessa Saint-Mezard, Maria Belen Alonso Ortiz, Melek Kechida, Nuria Fuertes Zamorano, Saturnino Suárez Ortega,

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. We describe four cases diagnosed in our hospital during the period 1999-2017. The patients were related to amiodarone ... Read more >>

Pan Afr Med J (The Pan African medical journal)
[2019, 34:7]

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Anesthesia for Endocrine Emergencies.

Dasun Peramunage, Sara Nikravan,

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 ... Read more >>

Anesthesiol Clin (Anesthesiology clinics)
[2020, 38(1):149-163]

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THE THYROID AND ITS DISEASES - A COMPREHENSIVE GUIDE FOR THE CLINICIAN.

Corin Badiu,

Acta Endocrinol (Buchar) (Acta endocrinologica (Bucharest, Romania : 2005))
[2018, 14(4):574-574]

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Initial low-dose oral levothyroxine in a child with Down syndrome, myxedema, and cardiogenic shock.

Annika Janson, Cathrin Hällström, Magnus Iversen, Mikael Finder, Amira Elimam, Ricard Nergårdh,

Myxedema is extremely rare in children, and guidelines are lacking. We treated a 12-year-old girl with myxedema and cardiogenic shock with initial low dose (0.3-2.5 μg/kg body weight/day) of oral levothyroxine and intensive care. Oral administration may safely revert children's myxedema in a dosage resembling that for hypothyroidism. ... Read more >>

Clin Case Rep (Clinical case reports)
[2019, 7(7):1291-1296]

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Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.

Richard G Trohman, Parikshit S Sharma, Elizabeth A McAninch, Antonio C Bianco,

Although amiodarone is considered the most effective antiarrhythmic agent, its use is limited by a wide variety of potential toxicities. The purpose of this review is to provide a comprehensive "bench to bedside" overview of the ways amiodarone influences thyroid function. We performed a systematic search of MEDLINE to identify ... Read more >>

Trends Cardiovasc. Med. (Trends in cardiovascular medicine)
[2019, 29(5):285-295]

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THYROTOXICOSIS IN A PEDIATRIC PATIENT WITH SUPRAVENTRICULAR TACHYCARDIA AND BORDERLINE FEATURES OF THYROID STORM.

Manthan Pandya, R Angel Garcia, Jeremy Awori,

Objective:The objective of this report was to emphasize the early recognition of thyrotoxicosis in the assessment of a pediatric patient with tachycardia. We present here the case of a 17-year-old female who presented with supraventricular tachycardia and was found to be in a state of severe thyrotoxicosis with borderline features ... Read more >>

AACE Clin Case Rep (AACE clinical case reports)
[2019, 5(6):e393-e395]

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Myxedema Coma Complicated by Pancytopenia.

Charles T Mupamombe, Felix M Reyes, Derek B Laskar, Joseph Gorga,

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 >>

Case Rep Med (Case Reports in Medicine)
[2019, 2019:2320751]

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[Thyroid Storm and Myxedema Coma].

Malte Milkau, Friedhelm Sayk,

Thyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show ... Read more >>

Dtsch. Med. Wochenschr. (Deutsche medizinische Wochenschrift (1946))
[2018, 143(6):397-405]

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SUN-550 Pressor Refractory, Liothyronine Responsive Myxedema Cardiogenic Shock without Myxedema Coma.

Cornelia Willis, Tonia Jenson, Jonathan Parks,

AbstractIntroduction: Typical features of severe hypothyroidism include myxedema coma with or without associated cardiogenic shock which manifests as persistent hypotension, hypothermia, and hypoventilation in the setting of other typical features of myxedema coma to include confusion and swelling in the face and extremities. No prior reports of myxedema cardiogenic shock ... Read more >>

J Endocr Soc (Journal of the Endocrine Society)
[2019, 3(Suppl 1):]

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SUN-586 A Case Of Myxedema Coma With A Surprising Twist of SubAcute Infarct In The Frontal Lobe.

Jonila Murati, Claudia Hill, Nkechi Mbaebie, Gabriela Ciofoaia, Hafez Alsmaan,

Abstract Myxedema Coma is a rare life threatening condition with a high mortality rate ranging from 25-60%. It results from longstanding, poorly controlled or undiagnosed hypothyroidism triggered by different precipitating factors including infections, cerebrovascular disease, myocardial infarction, and trauma or drug therapy. Hypothyroidism has a clear influence on atherosclerotic ... Read more >>

J Endocr Soc (Journal of the Endocrine Society)
[2019, 3(Suppl 1):]

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SUN-584 Unusual Presentation Of Myxedema Coma.

Jonila Murati, Preeyanka Sundar, Gabriela Ciofoaia, Brian Phillips,

Abstract Myxoedema coma is an uncommon, life-threatening form of longstanding, neglected, untreated hypothyroidism.It is precipitated by an acute illness such as infections, myocardial infarction, cold exposure, or use of sedative drugs. It is characterized by lethargy, myxedematous manifestations and altered sensorium. We are presenting a case of myxedema associated ... Read more >>

J Endocr Soc (Journal of the Endocrine Society)
[2019, 3(Suppl 1):]

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Myxedema Coma due to Hashimoto Thyroiditis: A Rare but Real Presentation of Failure to Thrive in Infancy.

Ryan A Heksch, Rohan K Henry,

BACKGROUND:Hashimoto thyroiditis (HT) is uncommon in infancy, and myxedema coma (MC) is even less common. While prior reports have documented these entities separately, to our knowledge, MC in combination with HT has not been reported before in this age group. METHODS/RESULTS:A 10-month-old female presented with ptosis, lethargy, dysphagia, and failure ... Read more >>

Horm Res Paediatr (Hormone research in paediatrics)
[2018, 90(5):332-336]

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SAT-619 Myxedema Coma: A Modern Day Rarity.

Aishwarya Ramachandran, Sumit Sohal, Sarah Ghaith, Faisal Qureshi,

Abstract : Myxedema coma is a rare, but severe form of hypothyroidism with a high mortality rate. : An eighty-nine-year-old female with a history of hypothyroidism and hypertension presented from a nursing home with lethargy, bradycardia, and hypothermia. She was oriented to self only, minimally verbal requiring assistance for activities ... Read more >>

J Endocr Soc (Journal of the Endocrine Society)
[2019, 3(Suppl 1):]

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SAT-624 Amiodarone-Induced Myxedema Coma.

Sanah Rana, Zoubair Ahmed,

Abstract Myxedema coma is an endocrine emergency. It is characterized by severe hypothyroidism resulting in altered mental status, bradycardia, and hypothermia. Hyponatremia, hypoglycemia, and hypoventilation may also be seen. Hypothyroidism is diagnosed with high serum TSH and low free T4 levels. Amiodarone is a commonly used medication used for ... Read more >>

J Endocr Soc (Journal of the Endocrine Society)
[2019, 3(Suppl 1):]

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SUN-566 Sspontaneous Oscillating Hypothyroidism and Hyperthyroidism: A Rare Autoimmune Entity.

Moutaz Ghrewati, FNU Komal, Vinod Kumar, Sushant Nanavati, Vora Aarohi, Mourad Ismail,

AbstractGraves disease is autoimmune thyroid disorder with overproduction of thyroid hormones secondary to production of TSH receptor antibodies (TSAB). Many of patients diagnosed with graves disease in end stage or after treatment with ablation therapy develop hypothyroidism need life long treatment with thyroxin replacement therapy its very common for Graves ... Read more >>

J Endocr Soc (Journal of the Endocrine Society)
[2019, 3(Suppl 1):]

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Myxedema coma precipitated by diabetic ketoacidosis after total thyroidectomy: a case report.

Jin Joo Kim, Eun Young Kim,

BACKGROUND:Myxedema coma is profound decompensated hypothyroidism usually precipitated by stressors, and its occurrence in association with total thyroidectomy or metabolic disorders, such as diabetic ketoacidosis, is unusual. CASE PRESENTATION:A 43-year-old Asian man with history of total thyroidectomy who was scheduled for a second radioactive iodine therapy presented to our hospital ... Read more >>

J Med Case Rep (Journal of medical case reports)
[2019, 13(1):50]

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Successful treatment of myxedema coma with a combination of levothyroxine and liothyronine.

Kazuhiro Ueda, Atsushi Kiyota, Mariko Tsuchida, Mikako Okazaki, Nobuaki Ozaki,

Myxedema coma is a rare endocrine emergency resulting from the decompensation of severe hypothyroidism, which is associated with a high mortality rate. It is characterized by the deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. Early disease diagnosis and advancements in intensive supportive care have reduced the mortality rate. ... Read more >>

Endocr. J. (Endocrine journal)
[2019, 66(5):469-474]

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