title: Severe hypothyroidism presenting as myxedema coma in the postoperative period in a patient taking sunitinib: case report and review of literature.
abstract: The case of a 62-year-old Caucasian woman who underwent urgent hip hemiarthroplasty for repair of a pathological fracture is reported. The patient's medical history was significant for renal cell carcinoma, cerebellar metastases, and sunitinib-induced hypothyroidism. Her intraoperative course was complicated by profound hypothermia, bradycardia, augmentation of neuromuscular blockade, delayed emergence, failure of postoperative extubation, and need for mechanical ventilation. The intensive care course was significant for hypothermia requiring forced-air warming, treatment with intravenous thyroxine (T4), and hemodynamic supportive care.
authors.affiliation: Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS 66160, USA. alele@kumc.edu
authors.forename: Abhijit V
authors.initials: AV
authors.lastname: Lele
authors.forename: Sarah
authors.initials: S
authors.lastname: Clutter
authors.forename: Eleana
authors.initials: E
authors.lastname: Price
authors.forename: Martin L
authors.initials: ML
authors.lastname: De Ruyter
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip; D003128:Coma / Q000139:chemically induced*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D008875:Middle Aged; D009230:Myxedema / Q000139:chemically induced*; D011183:Postoperative Complications / Q000139:chemically induced*; D011758:Pyrroles / Q000009:adverse effects*; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib