-
The Journal of the American Board of... 1995Myxedema coma in the elderly, although uncommon, is frequently overlooked and has a high mortality rate. Signs and symptoms are many and are often insidious. Nearly... (Review)
Review
BACKGROUND
Myxedema coma in the elderly, although uncommon, is frequently overlooked and has a high mortality rate. Signs and symptoms are many and are often insidious. Nearly every organ system is involved. Prompt recognition and treatment are mandatory for a successful outcome.
METHODS
A case study is presented. Using the key words "myxedema" with the word "aged," MEDLINE files were searched from 1989 to present. Articles dating before 1989 were accessed from the reference lists of the more recent articles.
RESULTS AND CONCLUSIONS
This review describes the signs and symptoms of myxedema coma in the elderly. Epidemiology and histopathology of the disorder are discussed. Prompt recognition and emergency medical treatment are essential for a successful outcome. Prevention requires screening of elderly patients at risk for hypothyroidism and assuring thyroid hormone replacement therapy.
Topics: Aged; Aged, 80 and over; Coma; Female; Humans; Male; Myxedema; Sex Factors
PubMed: 7484225
DOI: No ID Found -
The Medical Clinics of North America Jan 1995Myxedema coma is a fatal condition when left unrecognized. With the advent of intensive supportive therapy and the use of intravenous thyroxine, however, mortality for... (Review)
Review
Myxedema coma is a fatal condition when left unrecognized. With the advent of intensive supportive therapy and the use of intravenous thyroxine, however, mortality for this disorder is declining. Further insights into the pathophysiology of hypothyroidism should lead to more rational approaches to therapy and result in improved survival.
Topics: Coma; Emergencies; Humans; Myxedema; Prognosis; Thyroid Hormones
PubMed: 7808091
DOI: 10.1016/s0025-7125(16)30091-8 -
Archives of General Psychiatry Mar 1966
Topics: Adult; Female; Humans; Hyperthyroidism; Iodine Isotopes; Male; Middle Aged; Myxedema; Personality; Psychotic Disorders; Stress, Physiological; Thyroid Hormones; Thyroidectomy
PubMed: 5903420
DOI: 10.1001/archpsyc.1966.01730090053008 -
Thyroid : Official Journal of the... Sep 2018
Topics: History, 20th Century; Humans; Myxedema; Thyroid Hormones
PubMed: 30152719
DOI: 10.1089/thy.2018.0528 -
The American Journal of Digestive... Sep 1976A 74-year-old man presented with mental obtundation and massive ascites without evidence of significant impairment of liver function. Thyroid function studies suggested...
A 74-year-old man presented with mental obtundation and massive ascites without evidence of significant impairment of liver function. Thyroid function studies suggested hypothyroidism. Aspirated ascitic fluid had the characteristics of an exudate. Thyroid replacement therapy resulted in rapid clinical improvement with resolution of the ascites. Prompt recognition of myxedema ascites may prevent the inappropriate use of diuretic agents, therapeutic paracentesis, and sometimes unnecessary laparotomy.
Topics: Aged; Ascites; Diagnosis, Differential; Humans; Liver Diseases; Male; Myxedema
PubMed: 961677
DOI: 10.1007/BF01073036 -
AJR. American Journal of Roentgenology Jan 1978
Topics: Aged; Humans; Intestinal Obstruction; Male; Myxedema; Radiography
PubMed: 413409
DOI: 10.2214/ajr.130.1.175 -
American Family Physician Aug 1987
Topics: Ascites; Humans; Male; Middle Aged; Myxedema; Thyroxine
PubMed: 3618450
DOI: No ID Found -
Endocrinology and Metabolism Clinics of... Jun 1987Pretibial myxedema is considered an autoimmune complication or association of Graves' disease, Hashimoto's thyroiditis, and primary myxedema. The mechanism of lesion... (Review)
Review
Pretibial myxedema is considered an autoimmune complication or association of Graves' disease, Hashimoto's thyroiditis, and primary myxedema. The mechanism of lesion formation is unknown; the most plausible theory is that it arises as a result of a target cell in the skin, probably the fibroblast, being stimulated to produce abnormally high amounts of glycosoaminoglycans (especially hyaluronic acid) by autoantibodies directed against a thyroid antigen(s)--that is, by a cross reaction. One or more intermediary humoral agents may be involved in pathogenesis. The reason for the localization to the pretibial region is unknown; there is evidence that most patients with the disorder have similar abnormalities in the preradial skin. The condition may persist for months or years but often regresses spontaneously, accompanied by a parallel decline in, or disappearance of, serum anti-TSH-receptor autoantibody levels. Skin biopsies reveal evidence of increased amounts of hyaluronic acid and damage to collagen and elastic fibers. Local symptomatic treatment with corticosteroids is effective in most cases with slight to moderate severity of skin involvement. Repeated treatments are advised until such time that a spontaneous clinical remission occurs.
Topics: Adrenal Cortex Hormones; Graves Disease; Humans; Leg Dermatoses; Myxedema; Thyroiditis, Autoimmune
PubMed: 3319589
DOI: No ID Found -
Journal of Hospital Medicine Jan 2010
Topics: Aged, 80 and over; Female; Graves Disease; Humans; Leg Dermatoses; Myxedema
PubMed: 20063273
DOI: 10.1002/jhm.543 -
AACN Advanced Critical Care 2013Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema... (Review)
Review
Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema coma are endocrine emergencies resulting from thyroid hormone dysregulation, usually coupled with an acute illness as a precipitant. Careful assessment of risk and rapid action, once danger is identified, are essential for limiting morbidity and mortality related to thyroid storm and myxedema coma. This article reviews which patients are at risk, explains thyroid storm and myxedema coma, and describes pharmacological treatment and supportive cares.
Topics: Adult; Female; Humans; Male; Middle Aged; Myxedema; Thyroid Crisis; United States; Young Adult
PubMed: 23880755
DOI: 10.1097/NCI.0b013e31829bb8c3