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Abstract Myxedema crisis is a severe life threatening form of decompensated hypothyroidism which is associated with a high mortality rate. Infections and discontinuation of thyroid supplements are the major precipitating factors while hypothermia may not play a major role in tropical countries.
What is myxedema crisis?
Myxedema is a result of undiagnosed or untreated severe hypothyroidism. It can also develop when someone stops taking their thyroid medication. It’s more common in the elderly and women. Deposits of chains of sugar molecules in the skin cause the skin condition myxedema. These compounds attract water, which leads to swelling.
What causes myxedema?
In our experience quite a few patients with myxedema crisis have temperatures 2-3°F below normal although we also see patients with severe hypothermia. Infections and septicemia are the leading precipitating factors [2, 3]. Typical infections include pneumonia, urinary tract infections, and cellulitis.
What causes a low temperature in myxedema crisis?
Certain factors may suddenly trigger myxedema coma in a person with poorly controlled hypothyroidism. These include drugs (particularly sedatives, narcotics, anesthesia, lithium (Eskalith, Lithobid ), and amiodarone ( Cordarone ), infections, stroke, trauma, heart failure, digestive (gastrointestinal,...
What triggers a myxedema coma in hypothyroidism?
What triggers myxedema coma?
Multiple factors can precipitate myxedema coma (Table 1). Some of the more common precipitating factors include infections, particularly pneumonia and urosepsis, and certain medications. Another potential risk factor is failure to reinstate thyroid replacement therapy during hospitalization.
What causes thyroid crisis?
Thyroid storm occurs due to a major stress such as trauma, heart attack, or infection in people with uncontrolled hyperthyroidism. In rare cases, thyroid storm can be caused by treatment of hyperthyroidism with radioactive iodine therapy for Graves disease.
What happens during a myxedema crisis?
Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially women, and is associated with signs of hypothyroidism, hypothermia, hyponatremia, hypercarbia, and hypoxemia.
Why does myxedema occur in hypothyroidism?
Hypothyroid patients exhibit multiple physiologic alterations to compensate for the deficiency of thyroid hormone. Factors like infection can overwhelm these homeostatic mechanisms and can lead to myxedema coma. Myxedema coma can be an initial presentation of any form of hypothyroidism, irrespective of the cause.
How can thyroid crisis be prevented?
In addition to adhering to the therapy plan that their doctor prescribes, people with an overactive thyroid can help control their disorder by eating well, exercising, and keeping their stress to a minimum. The best way to prevent thyroid storm, however, is to address and treat the cause of hyperthyroidism correctly.
Can stress cause a thyroid storm?
Long-term stress can lead to having to adjust the amount of hormone needed. If an individual suffers from hyperthyroidism, or an overactive thyroid, chronic stress can spark what's known as a thyroid storm. This can be life threatening, with symptoms including high fever, rapid heartbeat and sweating.
Which finding is most likely in a patient who has myxedema?
Patients with myxedema coma usually have longstanding hypothyroidism, although it may not have been previously diagnosed. They often demonstrate classic symptoms of hypothyroidism: fatigue; constipation; weight gain; cold intolerance; a deep voice; coarse hair; and dry, pale, cool skin.
What hormone is responsible for myxedema?
Myxedema is a condition marked by thickening and swelling of the skin caused by insufficient production of thyroid hormones by the thyroid gland. The function of thyroid hormones is to regulate your metabolism.
When does myxedema occur?
Myxedema refers to a severe form of hypothyroidism than can occur when the condition is left untreated or is not treated sufficiently. The term also applies to the effects that hypothyroidism can have on the skin, making it appear swollen and puffy.
Can hyperthyroidism cause myxedema?
The lesions of localized myxedema which usually occur in the pretibial areas are also collections of mucin in the skin, as the name implies. These circumscribed lesions develop not in the hypothyroid patient as one might expect, but rather in the hyperthyroid individual who almost invariably has exophthalmos.
What is the TSH level in myxedema?
The thyroid stimulating hormone (TSH) level was extremely high (>150 uIU/mL; reference range, 0.55–4.78 uIU/mL).
Why do women get myxedema?
Hypothyroidism is more common in women, especially those over the age of 50, and can be caused by a viral infection, certain medications, radiation exposure, autoimmune disease, or inherited or congenital disorders. Myxedema is caused by hypothyroidism and occurs more frequently when hypothyroidism is left untreated.
What is a complication of myxedema?
Myxedema coma is a life-threatening complication of myxedema associated with severe hypothyroidism. Myxedema coma is usually the result of untreated severe hypothyroidism in combination with a triggering event, such as an infection.
What is the treatment for hypothyroidism underlying myxedema?
Treatment of hypothyroidism underlying myxedema. Thyroid hormone replacement therapy is required in most cases of hypothyroidism. These medications replace the thyroid hormone that is lacking in your body and must usually be taken for the rest of your life.
What is myxedema skin?
What is myxedema? Myxedema is a condition marked by thickening and swelling of the skin caused by insufficient production of thyroid hormones by the thyroid gland. The function of thyroid hormones is to regulate your metabolism. Myxedema is associated with other symptoms of underactive thyroid, also called hypothyroidism, including lethargy, ...
What are the symptoms of myxedema?
These symptoms include: Decreased senses of taste and smell. Fullness in the neck (a mass in the neck, called a goiter, is a very rare symptom) Thinning of hair, including eyebrows.
Can thyroid replacement help with myxedema?
Depending on the cause, myxedema can be treated with thyroid replacement hormones. These medications are effective in eliminating the symptoms that accompany myxedema and hypothyroidism. If you are prescribed thyroid replacement medications, you will probably need to take them for the rest of your life.
Can hypothyroidism cause myxedema?
Myxedema is caused by hypothyroidism and occurs more frequently when hypothyroidism is left untreated. Your health care professional can order simple blood tests to determine whether you have hypothyroidism, which can lead to myxedema. Depending on the cause, myxedema can be treated with thyroid replacement hormones.
What are the symptoms of myxedema?
People with myxedema coma may have symptoms and signs, for example: The body temperature is usually abnormally low ( hypothermia ), the core temperature may be as low as 80 F (26.6 C); Severe mental changes including hallucinations, disorientation, seizures, and ultimately, deep coma;
What are the mental changes that cause coma?
Severe mental changes including hallucinations, disorientation, seizures, and ultimately, deep coma; Significant swelling ( edema) all over the body with swollen eyes and thickening of the tongue, Sparse, dry hair, and loss of the outer thirds of the eyebrows; Difficulty breathing;
What is a coma in the brain?
Coma is a state of decreased consciousness whereby a patient cannot react with the surrounding environment. Myxedema (crisis) coma is a loss of brain function as a result of the severe, longstanding low level of thyroid hormone in the blood ( hypothyroidism ). Myxedema coma is considered a rare life-threatening complication ...
What is myxedema coma?
What Is Myxedema (Crisis) Coma? Definition and Facts. The thyroid gland, located at the front part of the neck, is responsible for making substances called thyroid hormones that are important for all body cells to work properly.
Can hypothyroidism cause myxedema?
If you have hypothyroidism, any of these conditions can contribute to myxedema coma, for example, infections, especially lung and urine infections, heart failure, stroke, trauma, surgery, drugs, such as phenothiazines, amiodarone, lithium, and tranquilizers, narcotics, and prolonged iodide use, and not taking prescribed thyroid medications.
Can myxedema be prevented?
Myxedema coma can be prevented with early treatment of hypothyroidism, taking thyroid medication regularly, and recognition of the warning symptoms of myxedema coma. It is a very serious condition that can result in death. Early and aggressive treatment can improve the outcome.
Does thyroxin cause adrenal crisis?
If adrenal insufficiency is present, then administration of thyroxin (in the thyroid medication) will provoke an adrenal crisis. Following the start of treatment, careful monitoring, usually in the intensive care unit, is necessary.
What is myxedema crisis?
Myxedema coma, also known as myxedema crisis, is a complication of advanced hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. This article explores how hypothyroidism causes myxedema coma, before detailing its symptoms, causes, treatment, and diagnosis.
Why is my thyroid not functioning properly?
Trusted Source. , the thyroid gland may not function properly from birth, resulting in mental and physical growth issues. Pituitary gland abnormalities: Pituitary tumors or pituitary surgery may affect the function of the gland. When this happens, the pituitary gland is unlikely to produce the right amount of TSH.
Can hypothyroidism cause myxedema?
Myxedema coma is a result of untreated or undiagnosed hypothyroidism. However, some contributing factors may trigger myxedema coma sooner in some people. If anyone has hypothyroidism, it is important that they try and keep warm.
Myxedema Symptoms
When your body lacks thyroid hormone, your heart rate slows down, your blood pressure lowers, and your temperature decreases—sometimes as low as in the 80s.
Causes
Myxedema coma can occur for a variety of reasons. However, all cases start when hypothyroidism goes untreated.
Diagnosis
Most people who seek care for myxedema coma are unaware of what’s going on around them. They are unable to answer simple questions and may not understand why they are in the hospital. In many cases, they are unable to explain their medical history or answer questions the medical staff may ask, making a quick diagnosis much more challenging.
Treatment
With myxedema, your doctor has four primary considerations for your treatment plan: hormone replacement therapy, steroid therapy, supportive care, and identifying what caused the situation in the first place. 2
A Word From VeryWell
Myxedema is a rare but dangerous condition. At this time, there are no at-home, over-the-counter, or homeopathic treatment options available for myxedema.
