Myxedema coma laboratory findings: Difference between revisions

Jump to navigation Jump to search
Line 4: Line 4:
==Overview==
==Overview==
==Laboratory Findings==
==Laboratory Findings==
Myxedematous coma should be considered in any patient who is comatose or who has some degree of deterioration of the sensorium with hypothermia or absence of fever in the presence of infection, hyponatremia and / or hypercapnia. Performing a thyroid routine test is considered best initial step in management of patients with myxedema coma.
Myxedematous coma should be considered in any patient who is comatose or who has some degree of deterioration of the sensorium with hypothermia or absence of fever in the presence of infection, hyponatremia and / or hypercapnia. Performing a thyroid routine test is considered best initial step in management of patients with myxedema coma.<ref name="pmid11130234">{{cite journal |vauthors=Wall CR |title=Myxedema coma: diagnosis and treatment |journal=Am Fam Physician |volume=62 |issue=11 |pages=2485–90 |year=2000 |pmid=11130234 |doi= |url=}}</ref>
*Serum TSH should be measured to distinguish primary hypothyroidism from the central.
*Serum TSH should be measured to distinguish primary hypothyroidism from the central.
*TSH might not be so as would be expected due to the presence of concomitant severe systemic disease("sick hypothyroid syndrome").
*TSH might not be so as would be expected due to the presence of concomitant severe systemic disease("sick hypothyroid syndrome").

Revision as of 01:17, 10 October 2017

Myxedema coma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Myxedema coma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Myxedema coma laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Myxedema coma laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Myxedema coma laboratory findings

CDC on Myxedema coma laboratory findings

Myxedema coma laboratory findings in the news

Blogs on Myxedema coma laboratory findings

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Myxedema coma laboratory findings

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

Overview

Laboratory Findings

Myxedematous coma should be considered in any patient who is comatose or who has some degree of deterioration of the sensorium with hypothermia or absence of fever in the presence of infection, hyponatremia and / or hypercapnia. Performing a thyroid routine test is considered best initial step in management of patients with myxedema coma.[1]

  • Serum TSH should be measured to distinguish primary hypothyroidism from the central.
  • TSH might not be so as would be expected due to the presence of concomitant severe systemic disease("sick hypothyroid syndrome").
  • The use of certain drugs such as dopamine or glucocorticoids also decrease the levels of TSH.
  • The levels of T4 and T3 (total and free fractions) will always be low.
  • In all cases measure cortisol and ACTH to evaluate or rule out the presence of primary adrenal insufficiency or secondary school.
  • CBC shows Anemia, leucopenia, hyponatremia, increased lactic dehydrogenase (LDH), creatine phosphokinase (CPK) and transaminases, hypercholesterolemia, increased creatinine and hypoglycemia.
  • Blood gases will reveal hypoxemia, hypercapnia and acidosis.

References

  1. Wall CR (2000). "Myxedema coma: diagnosis and treatment". Am Fam Physician. 62 (11): 2485–90. PMID 11130234.