What does myxedema coma look like?

Physical findings in myxedema coma (Table 2) may include the classic myxedematous face, which is characterized by generalized puffiness, macroglossia, ptosis, periorbital edema, and coarse, sparse hair. Nonpitting edema of the lower extremities is sometimes present.

How does amiodarone cause myxedema coma?

Myxedema coma is a syndrome caused by severe deficiency of thyroid hormone. Amiodarone, an iodinated derivative of benzofuran which bears structural similarity to the thyroid hormones tri-iodothyronine (T3) and tetra-iodothyronine (thyroxine or T4), can cause thyroid hypo- or hyperfunction.

What are the signs and symptoms of myxedema?

Myxedema Coma Symptoms

• Weakness or lethargy.
• Confusion or non-responsiveness.
• Feeling cold.
• Low body temperature.
• Swelling of the body, especially the face, tongue, and lower legs.
• Difficulty breathing.

How quickly can amiodarone affect thyroid?

Thyroid hormone profile in patients on amiodarone treatment After 1–4 months of amiodarone therapy, serum T4 levels increase by an average of 40% above pretreatment levels. It is important to note that the increase in T4 levels is an expected finding and in itself does not constitute evidence of hyperthyroidism.

Which person is most likely to experience a myxedema coma?

Anyone with hypothyroidism, a history of neck surgery, or radioactive iodine treatment could be at risk for this life-threatening complication. However, there are some higher risk groups, according to Dr. Leanna Poston, such as older women (over the age of 60) who have a history of primary hypothyroidism.

How is myxedema coma treated?

Patients with myxedema coma should be treated in an intensive care unit with continuous cardiac monitoring. Initial steps in therapy include airway management, thyroid hormone replacement, glucocorticoid therapy, and supportive measures.

Which is a characteristic of a patient with myxedema?

It often is possible to diagnose myxedema on clinical grounds alone. Characteristic symptoms are weakness, cold intolerance, mental and physical slowness, dry skin, typical facies, and hoarse voice. Results of the total serum thyroxine and free thyroxine index tests usually will confirm the diagnosis.

Does amiodarone damage the thyroid?

However, amiodarone is associated with a number of side effects, including thyroid dysfunction (both hypo- and hyperthyroidism), which is due to amiodarone’s high iodine content and its direct toxic effect on the thyroid.

How is amiodarone toxicity treated?

Amiodarone lung toxicity is a diagnosis of exclusion, and treatment includes simply withdrawing amiodarone, though steroids can be used in severe cases. A majority of patients improve significantly once amiodarone is stopped.

Can you recover from myxedema coma?

A person with myxedema is likely to stay in an intensive care unit with continual monitoring and treatment, and recovery may take several weeks. A myxedema coma requires immediate admission to a hospital. Treatment involves administering thyroid hormone replacement medication into a vein.

Why is hydrocortisone given in myxedema coma?

– It is generally deemed prudent to treat with hydrocortisone because of the possibility of coexistent primary or secondary adrenal insufficiency but also because of the possibility that thyroid hormone therapy may increase cortisol clearance and precipitate adrenal insufficiency – Hydrocortisone usually is given …

What medication is used for myxedema coma?

Mild cases may be treated with gradual oral replacement, but patients with myxedema coma usually require large doses of IV replacement. General guidelines suggest administration of intravenous levothyroxine at a dose of 500-800 mcg. Alternatively, intravenous liothyronine can be given at a dose of 25 mcg.