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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's characteristic physical sign is non-pitting edema, in contrast to pitting edema. [1] Myxedema can also occur in the lower leg (pretibial myxedema) and behind the eyes (exophthalmos). [citation needed] Severe cases, requiring hospitalization can exhibit signs of hypothermia, hypoglycemia, hypotension, respiratory depression, and coma.
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 ...
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]
[5] [10] Ιn fasting animals, administering leptin reverses NTIS symptoms and restores thyroid hormone concentrations. [5] In obesity, increased leptin increases TSH and T3, and lowers rT3, possibly as an attempt to increase energy expenditure and return to weight set point. [2] Other signals associated with hunger also affect the HPT axis.
The signs and symptoms of Graves' disease generally result from the direct and indirect effects of hyperthyroidism, although they can also be caused by other thyroidal conditions, such as Graves' ophthalmopathy, goitre and pretibial myxedema. These clinical manifestations can involve virtually every system in the body.
Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism.. It is a common cause of hyperthyroidism [2] [3] in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH).
Pretibial myxedema is almost always preceded by the ocular signs found in Graves' disease. [3] It usually presents itself as a waxy, discolored induration of the skin—classically described as having a so-called peau d'orange (orange peel) appearance—on the anterior aspect of the lower legs, spreading to the dorsum of the feet, or as a non-localised, non-pitting edema of the skin in the ...