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2012, Number 3

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Rev Cuba Endoc 2012; 23 (3)

Myxedema coma

Leal CL

Language: Spanish
References: 27
Page:
PDF size: 176.91 Kb.


ABSTRACT

Myxedema coma is the most severe and deepest form of hypothyroidism. It occurs more often in the women and the elderly. Among the unleashing factors found are sepsis, exposure to cold, acute severe events, use of anesthetic drugs, sedatives or narcotics as well as the interruption of the replacement treatment with thyroid hormones, among others. The clinical diagnosis is based on the presence of symptoms and signs that are characteristic of severe hypothyroidism, with hypothermia and altered consciousness. This diagnosis is also supported by the lab findings: hyponatremia, hypoxemia, hypercapnia, hemochemical alterations and the rise of thyrotropin due to the decrease of thyroid hormones in the case of the primary disease. The patient should be treated in an intensive care unit, by using monitoring, respiratory and cardiovascular support, internal body heating, hydration, correction of hypotension and control of electrolytic disorders. Additionally, glycocorticoids, broad-spectrum antibiotics and thyroid hormones should be administered. The progression of the disease depends on the delay in starting the treatment, the age, the comorbidities, the persistent hypothermia and the associated complications.


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