Myxedema Coma: Diagnosis And Treatment

Myxedema Coma: Diagnosis And Treatment

“What is myxedema coma?”

Clinical Features Of Myxedema

• General: There is tiredness, *somnolence, weight gain, cold intolerance, and goiter.
• Skin and subcutaneous tissue: Coarse dry skin, puffiness of the face with malar flush, baggy eyelids with swollen edematous appearance of supraclavicular regions, neck, and lack of hand and feet.
• Cardiovascular and respiratory features: Bradycardia, angina, cardiac failure, pericardial effusion, and pleural effusion.
• Neuromuscular features: Aches and pains, cerebellar syndrome with slurred speech and ataxia, muscle cramps, and stiffness.
• Gastrointestinal features: Constipation and ascites
• Developmental: Growth and mental retardation
• Reproductive system: Infertility, menorrhagia, hyperprolactemia, and galactorrhea.

Myxedema Coma: Diagnosis and Treatment

“Importance of early diagnosis of myxedema coma”

Diagnosis is based on the Clinical signs of the patient and the investigations

Clinical Signs Of Myxedema

• Cold intolerance
• Thickness and dryness of skin and hair,
• Swelling of hands and face
• Change in shape of face
• Thickening of lips is present

“Emerging research on myxedema coma treatments”

• Non-pitting edema is present
• There is a yellowish discoloration of the skin.
• Hoarseness of voice is present.
• There is a decrease or loss of sweating
• Loss of hair on the outer third of the eyebrows.
• Slow pulse/bradycardia.

Symptoms and Diagnosis of Myxedema Coma

“Treatment options for myxedema coma in ICU”

Investigations Of Myxedema

• Thyroid function test: There is a reduction in T3 and T4 levels and a rise in serum thyroid­stimulating hormone which indicates primary hypothyroidism.
• Reduction in T3 and T4 levels with TSH levels below normal range is secondary hypothyroidism.
• Serum cholesterol: It is raised in primary thyroid failure. The fall in serum level is more than 50 mg/100 mL.
• Tendon reflex duration is prolonged.
• In ECG bradycardia, low voltage complexes and flattened or inverted T­waves are present.