Myxedema coma Diagnosis and Treatment

Myxedema coma 

• This is a state of hypothyroidismACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » with altered con­sciousness or coma, sometimes seizures. There may be hypothermia.
• It is common in the elderly, and precipitated by seda-’ tives, antidepressants, pneumonia, CHF, MI, cere­brovascular accidents.
• marked by neurological dysfunction, by respiratory depressionVisada Depression Ayurveda and Modern. Read more ... », and by lowered body temperature, blood pressureChronic Long-term Complications Of Diabetes Mellitus. Read more ... », blood sugar, and serum sodiumRenin and Hypertension Low renin and High Renin essential hypertension with Treatment. Read more ... ».
• SystemTREATMENT OF HYPERTENSION Lifestyle modification WITH Drug treatment. Read more ... »(s) affected: EndocrineAldosteronism Clinical features Causes and Treatment. Read more ... »/Metabolic
• These patients may be hypoxaemic, hypercapneic, hyponatremic, hypoglycemic.

Myxedema coma Risk Factors

• History of Graves diseaseTREATMENT OF HYPERTENSION Lifestyle modification WITH Drug treatment. Read more ... »
• Increasing age
• Personal or family history of autoimmune diseases, including type 1 DM, Addison disease
• Previous head or neck irradiation
• Previous postpartum thyroiditisThyroid Goiter. Read more ... »
• Treatment with lithium, immune modulators such as IFN-, or the iodine-containing antiarrhythmic amiodarone

Myxedema coma DIAGNOSIS —

• The diagnosis of myxedema coma is initially based upon the history, physical examinationHow to take good medical history & examination. Read more ... », and exclusion of other causesTREATMENT OF HYPERTENSION Lifestyle modification WITH Drug treatment. Read more ... » of coma

Myxedema coma Initial Lab Tests

• •Primary hypothyroidism
  • Serum free T4 decreased
  • TSHACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » elevated
• •Central hypothyroidism:
  • Impaired TSH response to TRH
  • Serum free T4 decreased
  • TSH low
• •Severe hypothyroidism:
  • Hyponatremia
  • Elevated CPK, LDH, AST
  • Elevated cholesterol
  • Anemia
• •Subclinical hypothyroidism:
  • TSH elevated
  • Serum free T4 normal

Myxedema coma Treatment

• Levothyroxine-single IV bolus 500 mcg loading dose then 100 mcg/day. Levothyroxine may be given by nasogastric tubeInstruments & Procedures- Nasogastric tube. Read more ... » as crushed tablets.
• Patient is kept warm.
• Hydrocortisone IV 50 mg 6 hrly is given. Broad spectrum antibiotics for infection. Hypertonic saline and IV glucoseGlycogen Storage Diseases von Gierke disease, Andersen's disease, McArdle's disease. Read more ... ».