A Case of Refractory Myxedema Coma
| Autor: | Urja Patel, Dawn Maldonado, Nancy Tarlin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Bradycardia
Pediatrics medicine.medical_specialty business.industry General Engineering Levothyroxine Endocrinology/Diabetes/Metabolism Myxedema coma Emergency department 030204 cardiovascular system & hematology Delayed diagnosis medicine.disease 03 medical and health sciences 0302 clinical medicine Refractory myxedema coma Internal Medicine Medicine hypothyroidism medicine.symptom business Oral therapy 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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