A Case of Myxedema Coma with Severe Hypoventilation.
- Author:
Jin Young SHIM
1
;
Seung Won LEE
;
Hyun Woo LEE
;
Joon Hyuck CHOI
;
Young Jun SONG
;
Hyoung Suk LEE
;
Yoon Sok CHUNG
;
Kwan Woo LEE
Author Information
1. Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
- Publication Type:Case Report
- Keywords:
Myxedema;
Hypoventilation;
Respiratory insufficiency
- MeSH:
Airway Obstruction;
Coma*;
Consciousness;
Dyspnea;
Emergency Service, Hospital;
Hormone Replacement Therapy;
Humans;
Hypothyroidism;
Hypoventilation*;
Mortality;
Myxedema*;
Respiration;
Respiratory Insufficiency;
Seizures;
Thyroid Gland;
Thyroxine;
Ventilation
- From:Journal of Korean Society of Endocrinology
2004;19(2):203-208
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A myxedema coma, representing the extreme feature of hypothyroidism is rare. Despite early vigorous treatment, a myxedema coma is associated with a mortality rate as high as 60%. Herein, a case of a myxedema coma, with severe hypoventilation, is described. When the patient arrived at the emergency room, she complained of dyspnea and general weakness, and was of a drowsy mental status. 7 days after admission, she was more confused and disoriented, and respiratory insufficiency had developed. Although levothyroxine was continued and her respiration improved, she still had a confused mentality and seizure developed. Despite medication her consciousness did not improve, so was discharged in despair by her family members. The respiratory abnormality with a myxedema coma is a depressed ventilatory response to hypercapnea, resulting in a decrease in alveolar ventilation, with progressive CO2 retention. An upper airway obstruction, especially during sleep, and neuromuscular dysfunction in breathing may be shown in hypothyroidism. Therefore, a myxedema coma, accompanied by severe hypoventilation, should be intensively treated with thyroid hormone replacement therapy and mechanical ventilatory support
