Myxedema Coma (cont.)

Medical Author:

Ruchi Mathur, MD, FRCP(C)

Ruchi Mathur, MD, FRCP(C)

Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Most patients with myxedema coma have a history of hypothyroidism, thyroid surgery, or radioactive iodine treatment for thyroid disease. Very rarely, the problem is not caused by the inability of the thyroid gland to make thyroid hormone; but rather is caused by the failure of the pituitary gland or the hypothalamus to correctly signal the thyroid gland to perform its normal functions. In this situation, the thyroid gland is normal, but it is not receiving the signals from the pituitary gland or hypothalamus to make the thyroid hormone it is capable of producing.

Picture of the Thyroid Gland

 

Picture of the Pituitary Gland

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,
  
  
• gastrointestinal bleeding,
  
  
• hypothermia (abnormally low body temperature), and
  
  
• failing to take thyroid medications as prescribed.

Source: MedicineNet.com
http://www.medicinenet.com/myxedema_coma/article.htm