Myxedema coma history and symptoms: Difference between revisions

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===Myxedema===
===Myxedema===

Revision as of 07:29, 10 October 2017

Myxedema coma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

History

  • History of thyroid disease
  • History of radioiodine therapy or thyroidectomy,
  • Thyroid hormone therapy that was inappropriately discontinued

Symptoms

The function of all organ systems and various metabolic pathways are compromised in hypothyroidism. The cardinal symptoms of myxedema coma are the sensory impairment and hypothermia. The accumulation in the interstitial tissue of mucopolysaccharides and water leads to myxedema that compromises large part of the tissues. Symptoms of myxedema coma can be summarized in the following table:[1]

Organ system involved Manifestations
CNS
  • Lethargy
  • Poor memory
  • Cognitive dysfunction
  • Depression
  • Psychosis
  • Hypothermia
  • Focal or generalized seizures
Cardiovascular
  • SOB
  • Chest pain
  • Palpitations
  • Orthopnea
  • PND
  • Edema
Pulmonary
Gastro-intestinal
  • Anorexia
  • Nausea
  • Abdominal pain
  • Constipation
Renal and electrolyte
  • Bladder atony with urinary retention
Systemic
  • Sweats
  • Anorexia
  • Weakness
  • Sleep disturbances
Skin
  • Dryness
  • Rash
  • Perspiration

Myxedema

  • Myxedema is a defined as deposition of mucopolysaccharides in the dermis at periorbital level and is responsible for the typical bloated facies.
  • It is accompanied by thin, dry and brittle hair and even alopecia, loss of the tail of the eyebrows (sign of Queen Anne or supraciliar madarosis) and macroglossia, with cold skin (by reflex cutaneous vasoconstriction), pale-yellowish (from anemia and hypercarotinemia), dry, rough and rough (elephant skin).

Hypothermia

  • It is defined by the presence of core body temperature (rectal) <35 ° C, although in general it is serious, with records between 26 ° C and 32 ° C.
  • It is noted in most cases of myxedema coma, and due to a decrease in thermogenesis accompanying the decline of metabolism.
  • Hypoglycemia also complicates hypothermia.
  • There is a correlation between the degree of hypothermia and survival, with a worse prognosis for those with temperatures below 32 ° .
  • Occasionally, hypothermia may be absent in presence of serious infections. Thus, the diagnosis must be seriously considered in every afebrile patient with a serious underlying infection.

References

  1. Wartofsky L (2006). "Myxedema coma". Endocrinol. Metab. Clin. North Am. 35 (4): 687–98, vii–viii. doi:10.1016/j.ecl.2006.09.003. PMID 17127141.