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Myxedema coma is an extreme or decompensated form of hypothyroidism and while uncommon, is potentially lethal. [ 1 ] [ 2 ] [ 3 ] A person may have laboratory values identical to a "normal" hypothyroid state, but a stressful event (such as an infection, myocardial infarction , or stroke ) precipitates the myxedema coma state, usually in the elderly.
Myxedema is known to occur in various forms of hypothyroidism, as well as hyperthyroidism, including Graves disease. One of the hallmarks of Grave's disease is pretibial myxedema, myxedema of the lower limb. [2] Myxedema is more common in women than in men. [3] Myxedema can occur in: Hyperthyroidism, associated with pretibial myxedema and ...
Myxedema psychosis is a relatively uncommon consequence of hypothyroidism, such as in Hashimoto's thyroiditis or in patients who have had the thyroid surgically removed and are not taking thyroxine. A chronically under-active thyroid can lead to slowly progressive dementia , delirium , and in extreme cases to hallucinations , coma , or ...
The signs of myxedema can be seen in dogs, with prominence of skin folds on the forehead, and cases of myxedema coma are encountered. [13] The diagnosis can be confirmed by a blood test, as the clinical impression alone may lead to overdiagnosis.
Diagnosis is often delayed since most of the symptoms of adrenal insufficiency are nonspecific and develop insidiously. [5] Hypotension and shock that fail to respond to vasopressors or fluid resuscitation are the main signs of an adrenal crisis. [6] Those in an adrenal crisis can deteriorate quickly, usually within a few hours. [7]
Woltman's sign (also called Woltman's sign of hypothyroidism or, in older references, myxedema reflex [1]) is a delayed relaxation phase of an elicited deep tendon reflex, usually tested in the Achilles tendon of the patient. Woltman's sign is named for Henry Woltman, an American neurologist. [2]
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Though it only happens in 5–15% of cases, persistent hypothyroidism can develop years after the diagnosis. [6] [28] Recurrent de Quervain thyroiditis is rare, occurring in about 2% of cases, and usually manifests again within a year after diagnosis. But there have also been reports of late recurrences after several years.