A Case of Refractory Myxedema Coma.
| Autor: | Maldonado D; Internal Medicine, Mount Sinai Medical Center/Elmhurst Hospital Center, New York City, USA., Patel U; Internal Medicine, Mount Sinai Medical Center/Elmhurst Hospital Center, New York City, USA., Tarlin N; Endocrinology, Mount Sinai Medical Center/Elmhurst Hospital Center, New York City, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2020 Aug 14; Vol. 12 (8), pp. e9737. Date of Electronic Publication: 2020 Aug 14. |
| DOI: | 10.7759/cureus.9737 |
| Abstrakt: | We present a case of myxedema coma refractory to traditional treatments. Morbidity and mortality from myxedema coma are frequently due to a missed or delayed diagnosis. It tends to respond very well to intravenous levothyroxine replenishment as long as this treatment is initiated early. We report a case of a 71-year-old man who presented with altered mental status and severe bradycardia who was promptly diagnosed with myxedema coma on laboratory studies sent in the emergency department (thyroid-stimulating hormone 94.74, free T4 0.17, and free T3 0.69). However, while the diagnosis was recognized immediately, and he was treated aggressively with intravenous thyroxine replacement, he strangely remained refractory to treatment for a prolonged period of time. While he did respond to intravenous thyroxine initially, he dramatically decompensated each time he was transitioned to oral therapy. This case brings to question why rarely certain patients fail the transition to oral therapy, and how to treat these patients. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, Maldonado et al.) |
| Databáze: | MEDLINE |
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