Which tools may be helpful in the diagnosis of 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

A diagnostic scoring system for the diagnosis of myxedema coma has been proposed. [26] The scoring system gives points for the following indicators: hypothermia; lethargy, obtundation, stupor, or coma; anorexia, reduced intestinal mobility, or paralytic ileus; bradycardia, electrocardiogram changes, pericardial or pleural effusions, cardiomegaly or hypertension; hyponatremia, hypoglycemia, hypoxemia, hypercapnia or reduced glomerular filtration rate, and the presence of a precipitating cause. This scoring system was based on data derived from a small sample of 21 patients, which may limit its generalizability.

Another diagnostic tool, developed by Chiong et al, uses six variables to screen for myxedema coma, including heart rate, temperature, Glasgow coma scale score, TSH levels, free T4 levels, and precipitating factors. The investigators, whose work utilized 10 study patients and 13 controls, reported the tool’s sensitivity and specificity to be about 80%. [27]


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