What is myxedema coma (crisis)?

Updated: Oct 10, 2018
  • Author: Mohsen S Eledrisi, MD, FACP, FACE; Chief Editor: George T Griffing, MD  more...
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Answer

Myxedema coma, occasionally called myxedema crisis, is a rare life-threatening clinical condition that represents severe hypothyroidism with physiological decompensation. [1, 2]  The condition usually occurs in patients with long-standing, undiagnosed hypothyroidism and is usually precipitated by infection, cerebrovascular disease, heart failure, trauma, or drug therapy. Patients with myxedema coma are generally severely-ill with significant hypothermia and depressed mental status.

A medical emergency, myxedema coma requires immediate attention. If the diagnosis is suspected, immediate management is necessary before confirming the diagnosis due to the high associated mortality rate. Patients with myxedema coma should be treated in an intensive care unit with continuous cardiac monitoring. Initial steps in therapy include airway management, thyroid hormone replacement, glucocorticoid therapy, and supportive measures.


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