Myxedema Coma (cont.)

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What are triggers of myxedema coma?

Certain factors may suddenly trigger myxedema coma in a person with poorly controlled hypothyroidism. These include:

  • drugs (particularly sedatives, narcotics, anesthesia, lithium (Eskalith, Lithobid), and amiodarone (Cordarone),
  • infections,
  • stroke,
  • trauma,
  • heart failure,
  • gastrointestinal bleeding,
  • hypothermia (abnormally low body temperature), and
  • failing to take thyroid medications as prescribed.

What are the symptoms of myxedema coma?

When a patient presents with myxedema coma the following may be present:

  • the body temperature is usually abnormally low (hypothermia), the core temperature may be as low as 80 F (26.6 C);
  • severe mental changes including hallucinations, disorientation, seizures, and ultimately, deep coma;
  • significant swelling (edema) all over the body with swollen eyes and thickening of the tongue,
  • sparse, dry hair, and loss of the outer thirds of the eyebrows;
  • difficulty breathing;
  • collections of fluid around the lungs and heart (pleural effusion and pericardial effusions);
  • the heart may slow down and its ability to pump blood forward can be impaired;
  • the gastrointestinal tract does not function well and sometimes it becomes paralyzed, thereby necessitating surgery; and
  • blood test abnormalities are a result of the increased fluid in the body. For example, sodium levels drop because of dilution, which is caused by the body retaining extra water.
Medically Reviewed by a Doctor on 12/12/2013

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