Myxoedema coma: an almost forgotten, yet still existing cause of multiorgan failure.
A 48-year-old man was admitted to department of emergency medicine at a tertiary referral hospital due to dizziness and fatigue. Clinical features on admission were non-pitting oedema, dry skin, very sparse hair, a hoarse voice, hypothermia (rectal temperature 28.7°C), macroglossia, sinus bradycardia and slow cerebration. Blood tests revealed severe hypothyroidism. During admission, the patient developed respiratory failure, renal failure, bleeding symptoms and diffuse colitis. The patient was treated with hydrocortisone and levothyroxine and he survived miraculously. This case describes a patient with myxoedema coma with severe hypothermia and cardiac involvement with development of multiorgan dysfunction all linked to the severe depletion of triiodothyronine.
Department of Nephrology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Louise Havkrog
LH
Salomo
Adam Hoegsbro
AH
Laursen
Nanna
N
Reiter
Ulla
U
Feldt-Rasmussen
D001919:Bradycardia / Q000209:etiology / Q000628:therapy; D003128:Coma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000628:therapy; D008260:Macroglossia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D009230:Myxedema / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D013974:Thyroxine / Q000627:therapeutic use
D013974:Thyroxine