Myxedema coma: symptoms, causes, drugs, etc. • hello healthy

Definition

What is myxedema coma?

Myxedema coma or myxedema coma is a condition of loss of brain function due to very low levels of thyroid hormone in the blood for a long time (hypothyroidism). Myxedema coma is a life-threatening and fatal complication of hypothyrodism.

Quoted from American Family Physician, the term myxedema coma is often used interchangeably with hypothyroidism. This condition refers to the swelling of the skin and soft tissues that occurs in patients who are hypothyroid.

How common is this condition?

Myxedema coma is rare, but is more common in the elderly and women. The incidence increases in winter or when temperatures are very low. Myxedema coma can result in death.

This condition is more common in people aged 60 years or older. More than 90 percent of cases occur during winter.

Symptoms

What are the symptoms of myxedema coma?

The signs of hypothyroidism vary depending on the severity of the hormone deficiency. Problems tend to develop slowly, often lasting several years. Myxedema coma is a condition that can result from untreated hypothyroidism.

At first, you may experience almost no symptoms of hypothyroidism, such as fatigue and weight gain. However, a metabolism that continues to slow down as a result of getting older may show more obvious symptoms.

The signs and symptoms of this condition are:

• Weak body
• Dazed
• Feeling cold
• Low body temperature
• Swollen body
• Hard to breathe

People who experience this condition are usually in a coma or near coma, so they cannot function normally and must receive emergency care.

There may be some symptoms not listed above. Please consult your doctor for more information.

When should I see a doctor?

Patients with hypothyroidism who experience fever, changes in behavior and mental status, shortness of breath, or experience swelling of the hands or feet should be taken to the hospital immediately.

Cause

What causes myxedema coma?

If you have hypothyroidism, any of the following can trigger this condition:

• Infections, especially of the lungs and urinary tract
• Heart failure
• Stroke
• Trauma
• Operation
• Medicines, such as phenothiazines, amiodarone, lithium, sedatives, and prolonged use of iodide
• Do not take thyroid medication that has been prescribed by your doctor

In rare cases, the problem is not caused by the inability of the thyroid gland to make hormones, but rather due to the failure of the pituitary gland or hypothalamus to properly signal the thyroid gland to perform its normal function.

Diagnosis

How is myxedema coma diagnosed?

The doctor will perform blood tests to count the blood cell count, electrolytes, levels, and thyroid hormones. Tests will also be carried out to check if the liver and adrenal glands are still functioning properly.

Here are the three main things your doctor will check to diagnose this condition:

• Changed mental status. Usually drowsiness and lethargy lasts for months. Lethargy can progress through a trance, to a coma There may be a drop in consciousness in some transient episodes.

• Hypothermia. The lower the temperature, the worse the life expectancy. Please check the thermometer's ability to measure temperature drop accurately. With cold weather, body temperature can drop sharply. This condition mostly occurs during winter.
• Trigger condition. Precipitating conditions can cause this condition. These conditions include cold air, infections, drugs (diuretics, sedatives, and analgesics), trauma, stroke, heart failure, gastrointestinal bleeding. In addition, a history of hypothyroidism, neck surgery, or radioactive iodine treatment can also cause this disease.

Physical examination may reveal hypothermia, hypoventilation, hypotension, bradycardia, dry rough skin, macroglossia, and delayed deep tendon reflexes. The absence of mild diastolic hypertension in a patient with hypothyroidism is a warning sign of myxedema coma.

Meanwhile, laboratory tests can reveal anemia, hyponatremia, hypoglycemia, hypercholesterolemia, and high serum creatine kinase concentrations.

Treatment

The information below is not a medical consultation. ALWAYS consult a doctor for treatment information.

What is the treatment for myxedema coma?

In order not to become a myxedema coma, hypothyroidism must be treated. Hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, others).

This oral medication can restore adequate hormone levels to improve signs and symptoms of hypothyroidism.

People with myxedema coma should be admitted to the intensive care unit. Mechanical ventilation may be required. Heart status should be monitored carefully, especially after intravenous thyroid hormone replacement.

Patients with hypothermia should be treated with a regular blanket. The use of heating blankets should be avoided as they can lead to hypotension and cardiovascular collapse.

The following are treatment options for myxedema coma:

Thyroid hormone replacement

Any patient suspected of myxedema coma should be treated with thyroid hormone. If there is suspicion of an arrhythmic precipitation, you may be given large doses of intravenous levothyroxine.

Antibiotics

Infection is often the cause of decompensation, where the body loses its ability to maintain its functions. Therefore, the cause of infection should be determined by blood and urine tests, as well as chest X-ray. Your doctor may recommend that you do therapy with intravenous antibiotics.

Steroids

Hydrocortisone may be recommended by a doctor until adrenal insufficiency clears up. Hydrocortisone should be given intravenously at a dose of 100 mg every eight hours. An adrenocorticotropic hormone stimulation test may be given if clinically necessary.

The progression of myxedema coma is difficult to determine because reports of this condition are few. However, the severity of the condition is clear. One study cited in the American Family Physician, the death rate for this condition was around 30 percent, while another study showed a death rate of over 60 percent.

Factors associated with the development of this disease include advancing age, bradycardia, and persistent hypothermia.

Prevention

How to prevent myxedema coma?

To prevent myxedema coma, people with hypothyroidism need to see a doctor for regular health checks and blood checks. So that hypothyroidism does not get worse, adopt a healthy diet to treat the condition.

If you experience the symptoms listed above but don't have hypothyroidism, visit your doctor to consult about possible causes, as well as possible tests to check your thyroid balance.

If you have any questions, consult your doctor for the best solution to your problem.

Hello Health Group does not provide medical consultation, diagnosis or treatment.