Management of Myxedema Coma
Myxedema coma is the most severe manifestation of hypothyroidism. In spite of ready availability of sensitive thyrotropin assays, the recognition and treatment of myxedema coma remains a clinical challenge. It is typically caused by a precipitating event
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Aydin Uzun Pinar
Case Presentation A 60 year old woman with no known medical history presented to the hospital with confusion in the setting of longstanding weakness and fatigue. Her family members reported cold intolerance, constipation, weight gain and thickening of skin and hair. She denied any respiratory symptoms and fever. She reported that she had no contact with the health care system for the last 20 years. She took no medications and denied any history of substance use. On physical examination she was noted to have a rectal temperature of 32 ° C and sinus bradycardia with a heart rate of 24 beats per minute. Thyroid stimulating hormone level (TSH) was 42.4 and free thyroxine (T4) level was
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