Myxedema coma

Myxedema Coma Overview

Myxedema coma is a rare but serious complication of an extreme form of hypothyroidism known as myxedema. It is associated with decreased mental status, decreased cardiac output, and infection. The condition can lead to coma, which can, without immediate medical treatment, result in death.

Myxedema coma is most commonly seen in people over age 65, those with Type 2 diabetes, and those with underlying thyroid diseases.

Symptoms of Myxedema Coma

The symptoms of myxedema coma typically begin with signs of myxedema such as:

  • Extreme fatigue
  • Unexplained weight gain
  • Depression
  • Feeling cold or having a low body temperature
  • Enlarged tongue
  • Dry skin
  • Constipation

As the condition progresses, one may experience additional symptoms such as:

  • Decreased level of consciousness
  • Reduced heart rate and respiratory rate
  • Slowed movement
  • Swollen tissue
  • Shallow breathing
  • Confusion
  • Heart attack

Diagnosis of Myxedema Coma

Myxedema coma is often overlooked, as it is a medical emergency that requires immediate diagnosis and treatment. A diagnosis of myxedema coma is usually confirmed when there is an urgent need to address the decreased mental status associated with it.

In order to diagnose myxedema coma, doctors will usually order a variety of tests. These include:

  • Serum thyroid function tests
  • CBC
  • Chest X-ray
  • Urinalysis
  • Electrolyte levels

Depending on the patient’s physical symptoms and medical history, other tests may also be ordered to help diagnose myxedema coma.

Treatment of Myxedema Coma

The treatment of myxedema coma requires immediate medical attention. The primary goal of treatment is to stabilize the patient’s condition and diagnose any possible underlying infections.

Treatment generally includes:

  • Intravenous fluids
  • Antibiotics
  • Thyroid hormone replacement therapy
  • Glucocorticoid therapy
  • Glucose and electrolyte management
  • Cardiac and respiratory support

Once a patient’s condition has stabilized, long-term treatments which may include medications, lifestyle changes, and referral to a specialist, can be discussed.