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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When a patient presents with myxedema coma the following may be present:

• 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;
  
  
• 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;
  
  
• collections of fluid around the lungs and heart (pleural effusion and pericardial effusions);
  
  
• the heart may slow down and its ability to pump blood forward can be impaired;
  
  
• the gastrointestinal tract does not function well and sometimes it becomes paralyzed, thereby necessitating surgery; and
  
  
• blood test abnormalities are a result of the increased fluid in the body. For example, sodium levels drop because of dilution, which is caused by the body retaining extra water.

Initial laboratory evaluation usually includes a test for thyroid function (TSH, T3 and T4 levels). Other blood tests, as well as heart and lung function testing, may also be needed.

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