User:Mr. Ibrahem/Myxedema coma

Myxedema coma is a decompensated form of hypothyroidism. Typical symptoms include altered mental status and low body temperature. Other symptoms may include sleep apnea, puffy skin, hair loss, and abdominal bloating. Coma; however, is not typically present. Complications may include respiratory failure.

It generally occurs in those with hypothyroidism that is severe and untreated. Often an event such as dehydration, infection, or stroke triggers its development. Laboratory tests typical show a low thyroid state (low free T4 and high TSH). Other finding may include low blood pressure, slow heart rate, slow reflexes, low sodium, and low blood sugar.

Early treatment with thyroid hormone is key. This is generally given as a 300 to 500 ug intravenous dose of levothyroxine (T4), though some also use liothyronine (T3). Hydrocortisone 100 mg and antibiotics are also often given. While warming a person by giving heating intravenous fluids is reasonable, there are concerns that just warming a persons skin could further lower their blood pressure. Risk of death is about 20 to 50%.

Myxedema coma is rare affected about 1 in 5 million people per year. Those affected are usually older and female. Onset is often in the winter. The condition was initially described by Ord in 1879.