RESUMO
Hypothyroidism is a frequently diagnosed and simply treated disease. If not recognised, however, in time it may develop into the most severe manifestation of hypothyroidism known as myxedema coma. The term "myxedema coma" is generally seen as misleading since most patients do not initially present in a coma. The typical progression is lethargy evolving into stupor and, eventually, into coma with respiratory failure and hypothermia. It mainly affects elderly women, often occurring in winter and is relatively rare. It can be considered a form of decompensated hypothyroidism often triggered by a variety of non-thyroid conditions or diseases provoking an extremely severe condition of multiple system failure with lethal consequences unless an early diagnosis is made and an aggressive treatment is administered.
Assuntos
Coma/etiologia , Hipotireoidismo/complicações , Mixedema/etiologia , Coma/diagnóstico , Coma/fisiopatologia , Coma/terapia , Progressão da Doença , Humanos , Mixedema/diagnóstico , Mixedema/fisiopatologia , Mixedema/terapiaRESUMO
El hipotiroidismo es una enfermedad frecuente, de diagnóstico y tratamiento simples. Si no es detectada a tiempo puede progresar a la forma más grave conocida como coma mixedematoso. El término "coma mixedematoso" es considerado generalmente engañoso, ya que la mayoría de los pacientes no se presenta inicialmente en estado de coma. La progresión típica es la letargia, evolucionando al estupor y eventualmente al coma, con insuficiencia respiratoria e hipotermia. Es relativamente infrecuente, afecta fundamentalmente a mujeres ancianas, y a menudo ocurre en invierno. Esta entidad debe ser considerada una forma de hipotiroidismo descompensado, desencadenada a partir de una variedad de enfermedades o condiciones no tiroideas que provocan un compromiso sistémico generalizado de extrema gravedad, con desenlace fatal de no mediar un diagnóstico precoz y un tratamiento intensivo.
Hypothyroidism is a frequently diagnosed and simply treated disease. If not recognised, however, in time it may develop into the most severe manifestation of hypothyroidism known as myxedema coma. The term "myxedema coma" is generally seen as misleading since most patients do not initially present in a coma. The typical progression is lethargy evolving into stupor and, eventually, into coma with respiratory failure and hypothermia. It mainly affects elderly women, often occurring in winter and is relatively rare. It can be considered a form of decompensated hypothyroidism often triggered by a variety of non-thyroid conditions or diseases provoking an extremely severe condition of multiple system failure with lethal consequences unless an early diagnosis is made and an aggressive treatment is administered.
Assuntos
Humanos , Coma/etiologia , Hipotireoidismo/complicações , Mixedema/etiologia , Coma/diagnóstico , Coma/fisiopatologia , Coma/terapia , Progressão da Doença , Mixedema/diagnóstico , Mixedema/fisiopatologia , Mixedema/terapiaRESUMO
A 57 years old female suffered from recurrent attacks of ventricular tachycardia including one episode of torsade de pointes, she had hypothyroidism with myxedema secondary to Sheehan Syndrome, following thyroid replacement therapy the tachyarrhythmia did not relapse and there was no need to give specific antiarrhythmic therapy.
Assuntos
Mixedema/complicações , Torsades de Pointes/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Mixedema/terapia , Torsades de Pointes/terapiaAssuntos
Coma/terapia , Cuidados Críticos , Mixedema/terapia , Respiração Artificial , Insuficiência Respiratória/terapia , Adulto , Coma/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mixedema/complicações , Respiração com Pressão Positiva , Insuficiência Respiratória/etiologia , Tri-Iodotironina/administração & dosagemRESUMO
We report two cases of scleromyxedema treated with melphalan (alkeran) and dermabrasion, both patients with central nervous system involvement. In the first case, herpetic encephalitis, possibly due to the immunoglobulin disturbance, preceded the skin changes. In the second case, impaired cerebral function was caused by a meningeoma. In the first case of short duration it seems as if progression of the disease has been arrested. In the second, of more than 26 years duration the skin changes have seemed unchanged, sclerotic for some years, though some improvement was noticed following dermabrasion.