Alanís-Naranjo JM, Vega-Nava CT, Alanís-Naranjo ML, Bañuelos-Almada EA

Language: Spanish
References: 16
Page: 116-120
PDF size: 192.72 Kb.

ABSTRACT

Although SARS-CoV-2 infection is known to be an important cause of lung disease, multiple extrapulmonary manifestations associated with COVID-19 have been observed. There are reports of thyrotoxicosis secondary to COVID-19 in the literature, but cases of decompensated hypothyroidism due to COVID-19 are rare. We report the case of a 37-year-old female patient with obesity who presented myxedema coma associated with SARS-CoV-2 infection. The pro-inflammatory state secondary to obesity, direct damage to the thyroid gland by SARS-CoV-2, and the elevation of inflammatory mediators in the blood observed during viral infection could be mechanisms that trigger myxedema coma. In patients with severe COVID-19, the intentional search for signs of myxedema coma and its confirmation with a thyroid profile at hospital admission is important.

REFERENCES

1. Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017-1032. doi: 10.1038/s41591-020-0968-3.

2. Dixit NM, Truong KP, Rabadia SV, Li D, Srivastava PK, Mosaferi T, et al. Sudden cardiac arrest in a patient with myxedema coma and COVID-19. J Endocr Soc. 2020;4(10):bvaa130. doi: 10.1210/jendso/bvaa130.

3. Domínguez-Borgúa A, Fonseca-Entzana MT, Trejo-Martínez MA. Coma mixedematoso. Med Int Méx. 2015;31:223-228.

4. Pérez-Nieto OR, Álvarez-Cruz JC, López-Castro JH, Flores-Ramírez R, González-Toribio R, Ortega-Navarro HR, et al. Coma mixedematoso. Med Int Méx. 2020;36(6):859-867. Disponible en: https://doi.org/10.24245/mim.v36i6.3264

5. Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y. Clinical characteristics, and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. J Epidemiol. 2017;27(3):117-122. doi: 10.1016/j.je.2016.04.002.

6. Rebollo-Gómez H. Coma mixedematoso. Informe de un caso. Rev Med Inst Mex Seguro Soc. 2010;48(2):215-217.

7. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670-1751. doi: 10.1089/thy.2014.0028.

8. Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, et al. A diagnostic scoring system for myxedema coma. Endocr Pract. 2014;20(8):808-817. doi: 10.4158/EP13460.OR.

9. Mathew V, Misgar RA, Ghosh S, Mukhopadhyay P, Roychowdhury P, Pandit K, et al. Myxedema coma: a new look into an old crisis. J Thyroid Res. 2011;2011:493-462. doi: 10.4061/2011/493462.

10. Rizzo LFL, Mana DL, Bruno OD, Wartofsky L. Coma mixedematoso. Medicina (B Aires). 2017;77(4):321-328.

11. Wei L, Sun S, Xu CH, Zhang J, Xu Y, Zhu H, et al. Pathology of the thyroid in severe acute respiratory syndrome. Hum Pathol. 2007;38(1):95-102. doi: 10.1016/j.humpath.2006.06.011.

12. Wang W, Ye YX, Yao H. Evaluation and observation of serum thyroid hormone and parathyroid hormone in patients with severe acute respiratory syndrome. J Chin Antituberculous Assoc. 2003;25:232-234.

13. Pal R, Banerjee M. COVID-19 and the endocrine system: exploring the unexplored. J Endocrinol Invest. 2020;43(7):1027-1031. doi: 10.1007/s40618-020-01276-8.

14. Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med. 2020;383(23):2255-2273. doi: 10.1056/NEJMra2026131.

15. Zhu Z, Cai T, Fan L, Lou K, Hua X, Huang Z, et al. Clinical value of immune-inflammatory parameters to assess the severity of coronavirus disease 2019. Int J Infect Dis. 2020;95:332-339. doi: 10.1016/j.ijid.2020.04.041.

16. Van Gerwen M, Alsen M, Little C, Barlow J, Naymagon L, Tremblay D, et al. Outcomes of patients with hypothyroidism and COVID-19: a retrospective cohort study. Front Endocrinol (Lausanne). 2020;11:565. doi: 10.3389/fendo.2020.00565.