Myxedema Coma Patient in Emergency Department: A Case Report

Ko-Wen Han ； Chih-Chuan Lin ； Chih-Yu Chen ； Hsiao-Yun Chao ； Cheng-Yu Chien ； Hsien-Yi Chen

《Journal of Acute Medicine》 7卷4期 (2017/12) Pp. 171-173

https://doi.org/10.6705/j.jacme.2017.0704.006

摘要

Hypothermic patients are rare encountered in emergency department (ED). It often represents critical condition that needs prompt management and diagnosis. Myxedema coma, which may cause severe hypothermia, is truly an endocrine emergency and needs early recognition and proper treatment. We present a case of a 47-year-old female with a history of hyperthyroidism status post thyroidectomy was brought to the ED because of progressive dyspnea associated with general weakness for one month. Hypothermia with decreased mental status and general edema were also noted. Hypothyroidism was confirmed by laboratory examination and myxedema coma was diagnosed. The patient recovered well and there was no complication noted after intensive care with supplements of thyroxine and glucocorticoid. In conclusion, myxedema coma should be considered in decrease mental status and hypothermic patients with a history of hypothyroidism or thyroidectomy. Besides, long-standing hypothyroidism or encountering precipitating acute events, such as sepsis, cerebrovascular accident, gastrointestinal bleeding, exposure to cold, trauma or certain medications may also cause this condition. High mortality rate was reported, and the treatment should be instituted in patient with presumed myxedema coma without delay.

關鍵字

general edema ； hypothermia ； hypothyroidism ； myxedema coma ； thyroxine