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Ugeskrift For Laeger Aug 1984
Topics: Aged; Humans; Male; Myxedema; Psychotic Disorders; Suicide, Attempted
PubMed: 6515857
DOI: No ID Found -
BMJ Case Reports Sep 2010A 59-year-old man was referred for Mental Health Act Assessment following several months of 'odd behaviour' and self-neglect reported by his neighbours. He presented as...
A 59-year-old man was referred for Mental Health Act Assessment following several months of 'odd behaviour' and self-neglect reported by his neighbours. He presented as unkempt and expressed delusional ideas with respect to age, employment and identity of family members. He was fully oriented but lacked insight into his mental state and capacity for self-care. Physical examination revealed dry skin and slow relaxing reflexes. Blood investigations revealed a raised thyroid stimulating hormone and free T4 with positive thyroid peroxidise antibodies. MRI of the brain revealed frontal lobe and cerebellar atrophy, while neuropsychological assessment identified deficit in memory processing and executive functions. Despite appropriate correction of primary hypothyroidism with levothyroxine, the patient remained delusional with respect to age and employment although he showed some improvement in memory. Capacity for self-care remained poor; thus, he was eventually transferred to sheltered housing with rehabilitation.
Topics: Executive Function; Humans; Male; Memory Disorders; Middle Aged; Myxedema; Neuropsychological Tests; Psychotic Disorders; Thyrotropin
PubMed: 22778250
DOI: 10.1136/bcr.03.2010.2841 -
British Medical Journal Sep 1955
Topics: Body Temperature; Myxedema
PubMed: 13250218
DOI: No ID Found -
Cutis Nov 1979Scleromyxedema (also known as lichen myxedematosus or papular mucinosis) is a rare cutaneous disorder characterized by lichenoid waxy papules, sclerosis, and a...
Scleromyxedema (also known as lichen myxedematosus or papular mucinosis) is a rare cutaneous disorder characterized by lichenoid waxy papules, sclerosis, and a characteristic paraproteinemia. Rarely, if ever, is there systemic involvement. The cause and pathogenesis remain a mystery, however, a recent report has linked a serum factor with fibroblast proliferation in the skin. Treatment is often ineffective, although systemic melphalan may lead to improvement in 50 to 60 percent of patients. Morbidity and mortality due to melphalan used in the treatment of scleromyxedema have been reported, therefore, this therapy should be reserved for only the most extreme cases, if at all.
Topics: Adult; Antimetabolites; Female; Humans; Male; Myxedema; Prognosis; Skin Diseases
PubMed: 520033
DOI: No ID Found -
Journal of the American Academy of... Jul 1995Scleromyxedema is a rare fibromucinous disorder that is often difficult to treat and that is associated with significant morbidity and mortality. (Clinical Trial)
Clinical Trial
BACKGROUND
Scleromyxedema is a rare fibromucinous disorder that is often difficult to treat and that is associated with significant morbidity and mortality.
OBJECTIVE
Our purpose was to study the natural history of the disease and its response to therapy with alkylating agents.
METHODS
A clinicopathologic review of 26 patients with scleromyxedema was performed, and the extracutaneous findings and response to therapy with alkylating agents were noted.
RESULTS
Extracutaneous manifestations, most often gastrointestinal, were present in 20 of 26 patients. An abnormal paraprotein was found in 23 of 26 patients, most commonly IgG-lambda (18 patients). Melphalan was used as therapy for 17 patients. The disease proved fatal in 10 of the treated patients.
CONCLUSION
The overall prognosis in scleromyxedema is poor. Therapy is difficult. Although alkylating agents may prove beneficial in the short term, significant toxicity of these agents is apparent with long-term use.
Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Male; Melphalan; Middle Aged; Myxedema; Sclerosis; Skin
PubMed: 7601944
DOI: 10.1016/0190-9622(95)90007-1 -
Archives of Dermatology Jan 1976An unusual, nodulocystic form of scleromyxedema (lichen myxedematosus) developed in a 48-year-old man with a six-year history of psoriasis. The scleromyxedema responded...
An unusual, nodulocystic form of scleromyxedema (lichen myxedematosus) developed in a 48-year-old man with a six-year history of psoriasis. The scleromyxedema responded to intermittent therapy with melphalan and prednisone. Dermabrasion smoothed and softened the skin and increased the mobility of the perioral skin. Two months after remission of the skin lesions, psoriasis recurred.
Topics: Dermabrasion; Humans; Male; Melphalan; Middle Aged; Mucopolysaccharidoses; Myxedema; Paraproteinemias; Prednisone; Psoriasis; Recurrence; Skin Diseases
PubMed: 813582
DOI: No ID Found -
QJM : Monthly Journal of the... Apr 2021
Topics: Hashimoto Disease; Humans; Myxedema; Thyroid Neoplasms
PubMed: 33331641
DOI: 10.1093/qjmed/hcaa328 -
Bailliere's Clinical Endocrinology and... Jan 1992Thyroid storm is a rapid decompensation of severe hyperthyroidism which can best be described by the three criteria of hyperthermia, tachycardia and altered mental state... (Review)
Review
Thyroid storm is a rapid decompensation of severe hyperthyroidism which can best be described by the three criteria of hyperthermia, tachycardia and altered mental state with severe agitation. There has to be a precipitating factor such as infection, iodine contamination, surgery or even I-131 treatment. Severe hyperthyroidism not fulfilling the criteria of thyroid storm can also be an indication for emergency treatment, particularly in the elderly with heart disease. Suppressed serum TSH and elevated free T4 levels are essential to confirm the diagnosis. When rapidly available, radioiodine uptake of the thyroid can be useful. Therapy aims at rapidly reducing the active circulating hormone pool, hypermetabolic state, tachycardia, and finally hormone synthesis. Thyroid secretion can be blocked by ioipanoic acid or ipodate while hypermetabolic state can be reduced with beta-blockers or calcium channel-blockers. Treatment of hyperthyroidism in patients with iodine contamination is a real therapeutic challenge. Myxoedema coma, a complication of severe hypothyroidism, is defined by hypothermia (rectal temperature less than 36 degrees C), bradycardia, slow mentation, precipitating factor such as infection or drug overdose, and increased serum creatine phosphokinase levels. Diagnosis of severe hypothyroidism should be confirmed by serum measurements of TSH and free T4. Treatment consists of general supporting measures including rewarming, correction of serum electrolyte disturbances, and adequate alimentation. Thyroid hormone treatment should initially be aggressive using either 300-400 micrograms of T4 or 20-40 micrograms of T3 intravenously. Cortisone therapy may be added. Patients should be under close monitoring as arrhythmias and myocardial infarction are frequent complications of myxoedema coma and/or its treatment with thyroid hormones.
Topics: Acute Disease; Coma; Emergencies; Humans; Myxedema; Thyroid Crisis; Thyroid Diseases
PubMed: 1739398
DOI: 10.1016/s0950-351x(05)80332-5 -
The American Journal of Psychiatry May 1985
Topics: Female; Humans; Middle Aged; Myxedema; Neurocognitive Disorders; Thyroxine
PubMed: 3985205
DOI: 10.1176/ajp.142.5.655b -
The Journal of the Association of... Aug 2017Thyroid emergencies are major life-threatening endocrine conditions associated with life-threatening disorders resulting from either severe deficiency or excess of... (Review)
Review
Thyroid emergencies are major life-threatening endocrine conditions associated with life-threatening disorders resulting from either severe deficiency or excess of thyroid hormones. Deficiency of thyroid hormones may present as myxedema coma whereas excessive hormone production can present as life threatening thyrotoxic storm. The diagnosis of both requires a high index of clinical suspicion. Thyroid storm, in spite of accurate diagnosis, continues to have high fatality, whereas myxedema management has markedly improved with advancement in intensive care facility. The key to successful management of these emergencies is timely diagnosis and management by experienced physician in an intensive care setting. This article discusses the basic differences of both entities with an attempt to appropriate recognition and awareness of clinical signs and symptoms, highlight the salient diagnostic points and delineate the rational approach, which can lead to appropriate treatment at the earliest and reduce mortality.
Topics: Acute Disease; Humans; Myxedema; Thyroid Crisis
PubMed: 28799309
DOI: No ID Found